This community-based cross-sectional survey was conducted among 3852 caregiver-child pairs in Zhejiang Province from December 2019 to January 2020. Children aged 0 to 3 years were recruited from China\'s Early Childhood Development Program (ECD). Local child health care providers conducted face-to-face interviews with the primary caregivers. Demographic information of the participants was collected by questionnaire. Each child was screened for parental risk through the Parental Risk Checklist designed by the ECD program. The Ages and Stages Questionnaire (ASQ) was used to identify children with potential developmental delays. Multinomial logistic regression model and linear trend test were applied to assess the association between parental risks and suspected developmental delays.
Among the 3852 children included in the analyses, 46.70% had at least one parental risk and 9.01% presented suspected developmental delays in any domain of ASQ. Parental risk was statistically associated with the overall suspected developmental delay in young children (Relative Risk Ratio (RRR): 1.36; 95% confidence interval (CI): 1.08, 1.72; P = 0.010) after adjusting potential confounders. Compared with children with no parental risk, children exposed to 3 or more parental risks had 2.59, 5.76, 3.95, and 2.84 times higher risk of the suspected developmental delay in overall ASQ, communication, problem-solving, and personal-social domain, respectively (P values < 0.05). The linear trend tests found that the more parental risks, the higher possibility of developmental delay (P values < 0.05).
Parental risks are prevalent among children under three years in rural East China, which may increase the risk of developmental delays in children. Meanwhile, parental risk screening can be used to recognize poor nurturing care in primary health care settings. Targeted interventions are warranted to improve nurturing care for optimal early childhood development.
方法:这项基于社区的横断面调查于2019年12月至2020年1月在浙江省的3852对照顾者-儿童中进行。从中国儿童早期发展计划(ECD)招募0至3岁的儿童。当地儿童保健提供者与主要照顾者进行了面对面的访谈。通过问卷调查收集参与者的人口统计信息。通过ECD计划设计的“父母风险清单”对每个孩子进行父母风险筛查。年龄和阶段问卷(ASQ)用于识别潜在发育迟缓的儿童。应用多项逻辑回归模型和线性趋势检验来评估父母风险与可疑发育迟缓之间的关系。
结果:在纳入分析的3852名儿童中,46.70%的人至少有一个父母风险,9.01%的人在ASQ的任何领域都有怀疑的发育迟缓。调整潜在的混杂因素后,父母的风险与幼儿整体怀疑的发育延迟有统计学关联(相对风险比(RRR):1.36;95%置信区间(CI):1.08,1.72;P=0.010)。与没有父母风险的孩子相比,在总体ASQ中,暴露于3个或更多父母风险的儿童有2.59、5.76、3.95和2.84倍的疑似发育迟缓风险,通信,解决问题,和个人社会领域,分别为(P值<0.05)。线性趋势检验发现,父母的风险越高,发育迟缓的可能性越高(P值<0.05)。
结论:在中国东部农村地区,3岁以下儿童普遍存在父母风险,这可能会增加儿童发育迟缓的风险。同时,父母风险筛查可用于识别初级卫生保健机构中不良的养育护理。有针对性的干预措施是必要的,以改善最佳的幼儿发展的养育护理。