小于胎龄儿幼儿期生活质量及其影响因素的研究

Quality of life and its influencing factors in small for gestational age infants during early childhood

摘要:

目的 了解小于胎龄儿(SGA)幼儿期的生活质量与适于胎龄儿(AGA)比较是否存在差异,并调查影响SGA 生活质量的因素.方法 采用婴幼儿生活质量问卷表(ITQOL SF-47)对儿保门诊就诊的出生时为SGA 和AGA 的1~3 岁幼儿进行生活质量调查,分别比较SGA 组(n=203)与AGA 组(n=130)、SGA 追赶组(n=119)与无追赶组(n=84)、SGA 首次儿保随访组(n=144)与多次儿保随访组(n=59)的生活质量.采用广义线性模型分析法调查影响SGA 生活质量的因素.结果 SGA 组ITQOL 总分低于AGA 组(630±99 vs 716±84,P<0.05);SGA 无追赶组的ITQOL 总分低于追赶组(602±96 vs 649±97,P<0.05);SGA 首次儿保随访组的ITQOL 总分低于多次儿保随访组(616±94 vs 657±107,P<0.05).广义线性模型分析显示,有追赶生长、多次儿保随访、女性、母亲文化程度高以及居住在重庆主城区的SGA 幼儿ITQOL 总分高(P<0.05).结论 SGA 幼儿期的生活质量低于同龄正常儿童.适当促进追赶生长及定期儿童保健对提高SGA 的生活质量有益;儿童性别、居住地、母亲文化程度对SGA 幼儿期的生活质量也有影响.

Abstract:

Objective To investigate the difference in quality of life (QOL) between small for gestational age (SGA) and appropriate for gestational age (AGA) infants during early childhood, and to investigate the factors influcing the QOL. Methods The Infant and Toddler Quality of Life Questionnaire-47 (ITQOL-SF47) was used to investigate the QOL of 1 to 3-year-old children born SGA and AGA who visited the child health care division. QOL was compared between SGA (n=203) and AGA groups (n=130), between the catch-up (n=119) and no-catch-up subgroups (n=84) of children born SGA, and between the single healthcare (n=144) and multiple healthcare subgroups (n=59) of children born SGA. The generalized linear model was used to investigate the factors influencing the QOL. Results The total ITQOL score of the SGA group was significantly lower than that of the AGA group (630±99 vs 716±84; P<0.05). In children born SGA, the no-catch-up subgroup had a significantly lower total ITQOL score than the catch-up subgroup (602±96 vs 649±97; P<0.05), and the single healthcare subgroup had a significantly lower total ITQOL score than the multiple healthcare subgroup (616±94 vs 657±107; P<0.05). The generalized linear model analysis showed that in children born SGA who had catch-up or multiple healthcare visits, who were female or living in the Chongqing urban area, or their mothers had a higher educational levels had higher total ITQOL score. Conclusions SGA infants have lower QOL than AGA infats during their early childhood. Proper promotion of catch-up growth and regular healthcare visits will contribute to the improvement of the QOL of SGA infants. The QOL of SGA infants is also influcenced by children's sex, residence and the degree of mothers' educational levels.