背景:尽管过去十年儿童生存率有了很大改善,低收入和中等收入国家(LMICs)的许多儿童仍然面临因营养不良而无法发挥其发育潜能的风险,健康状况不佳,缺乏刺激。产妇的参与和刺激已被确定为儿童健康发展的一些最关键的投入。然而,在撒哈拉以南非洲(SSA),关于产妇刺激与儿童发育之间联系的证据相对较少。本文旨在确定肯尼亚和赞比亚的产妇刺激与儿童发育之间的关联。以及在这些环境中最能预测发展结果的活动。
方法:我们使用来自肯尼亚和赞比亚的前瞻性研究数据进行了描述性研究。该研究包括三轮数据收集。儿童在第一轮平均10个月大,第二轮25个月大,在第三轮中36个月大。感兴趣的主要暴露变量是母体刺激活动,我们把它归类为认知,语言,电机,和社会情感活动。感兴趣的结果是通过第三版年龄和阶段问卷(ASQ-3)测量的儿童发育。在三轮调查中,使用线性回归模型来估计总体母体刺激和特定领域母体刺激与儿童发育之间的关联。
结果:在校正其他混杂因素后,较高的母体刺激评分与较高的ASQ评分相关(效应大小=0.25;95%CI:0.19,0.31)。对于特定领域和儿童发展(ASQ分数),语言刺激的效应大小(ES)最大(ES=0.15),而社会情绪领域活动的关联最弱(ES=-0.05).总体母体刺激与粗大运动发育最相关(ES=0.21),与解决问题的关系最小(ES=0.16)。
结论:我们的研究结果表明,在贫困农村地区的社区中,母亲的刺激活动与儿童的发育结果之间存在很强的正相关。
背景:NA(非临床试验)。
Despite major improvements in child survival over the past decade, many children in low and middle-income countries (LMICs) remain at risk of not reaching their developmental potential due to malnutrition, poor health, and a lack of stimulation. Maternal engagement and stimulation have been identified as some of the most critical inputs for healthy development of children. However, relatively little evidence exists on the links between maternal stimulation and child development exists in sub-Saharan Africa (SSA). This current paper aims to identify the associations between maternal stimulation and child development in Kenya and Zambia, as well as the activities that are most predictive of developmental outcomes in these settings.
We conducted a descriptive study using data from a prospective study in Kenya and Zambia. The study included three rounds of data collection. Children were on average 10 months old in round one, 25 months old in round two, and 36 months old in round three. The primary exposure variable of interest was maternal stimulation activities, which we grouped into cognitive, language, motor, and socio-emotional activities. The outcome of interest was child development measured through the Third Edition of the Ages and Stages Questionnaire (ASQ-3). Linear regression models were used to estimate the associations between overall maternal stimulation and domain-specific maternal stimulation and child development across the three rounds of the survey.
Higher maternal stimulation scores were associated with higher ASQ scores (effect size = 0.25; 95% CI: 0.19, 0.31) after adjusting for other confounders. For domain specific and child development (ASQ scores), the largest effect size (ES) was found for language stimulation (ES = 0.15) while weakest associations were found for socio-emotional domain activities (ES= -0.05). Overall maternal stimulation was most strongly associated with gross motor development (ES = 0.21) and the least associated with problem-solving (ES = 0.16).
Our study findings suggest a strong positive link between maternal stimulation activities and children\'s developmental outcomes among communities in poor rural settings.
NA (not a clinical trial).