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背景:学龄前儿童行为问题的发生不但影响儿童时期的生活质量,而且可以预测成年后发生精神障碍的危险性。目的:探讨4～5岁儿童行为问题发生与其性别及母乳喂养的关系。设计:分层整群抽样调查。单位:青岛大学医学院附属医院儿童保健科;青岛大学医学院预防医学教研室。对象:采用分层整群抽样方法抽取2004-05青岛市市内4区的10所幼儿园4～5岁儿童600人,男301人,女299人。入组儿童均为足月顺产儿。方法:采用Achenbach儿童行为量表和自制的儿童行为影响因素问卷,对儿童进行调查。以行为问题的有无为因变量,以生后喂养情况、母乳喂养持续时间为自变量分性别进行单因素和多因素非条件Logistic回归分析。主要观察指标:母乳喂养情况、母乳喂养持续时间及行为发育状况。结果:按意向处理分析,完成调查儿童600人。①在所调查的儿童600人中,儿童行为问题检出率为14.2%(85/600),其中男童的行为问题检出率为17.94%(54/301),女童的行为问题检出率为10.4%(31/299),男、女童行为问题检出率比较,有明显差异(χ2=7.07,P<0.01)。②单因素Logistic回归显示,“主要喂奶粉”、“只喂奶粉”是男童行为问题的危险因素(OR=2.72,4.29),“母乳喂养持续时间≥9个月”是男童行为问题的保护因素(OR=0.43);“主要喂母乳”、“主要喂奶粉”、“只喂奶粉”、“母乳喂养持续时间<1个月”是女童行为问题的危险因素(OR=2.55,7.79,7.79,2.76)。③以喂养方式、母乳喂养持续时间为自变量,行为问题的有无为因变量进行多因素Logistic回归显示,“只喂奶粉”和“母乳喂养持续时间≥9个月”分别是男童行为问题发生的危险因素和保护因素(OR=3.76,0.45);“主要喂母乳”、“主要喂奶粉”和“只喂奶粉”仍是女童行为问题发生的危险因素(OR=2.55,7.79,7.79),与单因素结果相似。④校正了家庭年收入、父母亲受教育水平后,“只喂奶粉”和“母乳喂养持续时间≥9个月”仍分别是男童行为问题发生的危险因素和保护因素(OR=3.48,0.45);“主要喂母乳”、“主要喂奶粉”和“只喂奶粉”仍是女童行为问题发生的危险因素(OR=2.49,9.81,12.89)。结论:男性是儿童行为问题的危险因素;母乳喂养量少和母乳喂养持续时间短是4～5岁儿童行为问题发生的危险因素。
Background: The occurrence of behavioral problems in preschool children not only affects the quality of life in childhood, but also predicts the risk of developing mental disorders in adulthood. Objective: To investigate the relationship between behavior problems of 4 ~ 5 years old children and their gender and breastfeeding. Design: Stratified cluster sampling survey. Unit: Department of Child Health, Affiliated Hospital of Qingdao University Medical College; Department of Preventive Medicine, Qingdao University Medical College. PARTICIPANTS: A total of 600 children, aged 4 to 5 years old, 301 males and 299 females from 10 kindergartens in 4 districts of Qingdao City were recruited by stratified cluster sampling method. All children in the group were full-term follow-up. Methods: Achenbach children’s behavior scale and self-made questionnaire of influencing factors of children’s behavior were used to investigate children. Univariate and multivariate non-conditional logistic regression analysis were conducted to determine the presence or absence of behavioral problems and the postnatal feeding status and breastfeeding duration as independent variables. MAIN OUTCOME MEASURES: Breastfeeding, breastfeeding duration and behavioral development. Results: According to the analysis of intention to deal with the completion of the investigation of 600 children. ① Among the 600 children surveyed, the detection rate of children’s behavior problems was 14.2% (85/600), of which, the detection rate of behavior problems among boys was 17.94% (54/301). The detection rate of behavior problems among girls Was 10.4% (31/299). There was a significant difference in the detection rate of male and female behavior problems (χ2 = 7.07, P <0.01). ② Logistic regression showed that “main feeding milk” and “feeding only milk powder” were risk factors for boy behavior problems (OR = 2.72,4.29), “breastfeeding duration≥9 months” was a problem of boy behavior (OR = 0.43). The main risk factors for girls’ behavioral problems were “primary breastfeeding”, “main feeding milk”, “feeding only milk” and “breastfeeding duration <1 month” (OR = 2.55,7.79, 7.79, 2.76). ③ Logistic regression analysis showed that “Breastfeeding only” and “Breastfeeding duration> 9 months” were the cause of boys’ behavior problems, respectively, with feeding duration, duration of breastfeeding as independent variable and behavioral problems as dependent variable (OR = 3.76, 0.45). The main risk factors of breast-feeding were ORFs (OR = 2.55, 7.79, 7.79) Similar to the one-way result. ④ After correcting the annual family income and the level of education of parents, “only feeding milk powder” and “breast-feeding duration> 9 months” are still the risk factors and protective factors of boy’s behavior problems respectively (OR = 3.48,0.45 ). “Mainly breastfeeding”, “main feeding milk” and “feeding only milk powder” are still risk factors for girls’ behavioral problems (OR = 2.49,9.81,12.89). CONCLUSIONS: Men are a risk factor for behavioral problems in children; low breastfeeding and short breastfeeding duration are risk factors for behavioral problems in children aged 4 to 5 years.