关键词: 回应性照护, 儿童早期发育, 出生队列研究

Abstract: Objective To analyze the influence of responsive caregiving at 2 months of age on the development of 2-month-old and 6-month-old infants and to provide evidence for the promotion of the nurturing care framework for early childhood development published by WHO in China. Methods From April 2016 to October 2018, the baseline information of pregnant women from Shanghai Maternal-Child Pairs Cohort was collected at enrolment and the infants were followed up until they were 6 months old.Information of maternal pregnancy-related condition and infants′ general condition were obtained from obstetric record.The practices of responsive caregiving at 2 months of age were evaluated by self-administered questionnaire.The infant development was assessed by the third edition of Ages and Stages Questionnaire (ASQ-3) at 2 months old and 6 months old. Results A total of 2 853 infants were followed up at the age of 2 months and 1 850 of them were followed up at 6 months of age.Apart from 2 items of offering infants skin-to-skin contact and positive interaction as 91.0% and 92.1%, respectively, the remaining 4 items reached relatively higher rates.Univariate analysis showed that annual household income, maternal educational level and maternal postpartum depression were significantly associated with the adequacy of responsive caregiving at age of 2 months (all P＜0.05).After adjustment for potential confounders, multivariable unconditional logistic regression analysis showed that compared to infants in adequate responsive caregiving group, the risk of developmental delay on gross motor, fine motor, problem solving, and personal-social scales among infants in the inadequate group increased significantly by 125%,442%,167% and 162% at 2 months of age, and the risk of developmental delay on personal-social scale increased significantly by 129% at 6 months of age.In addition, infants in the general group had a 222% increased risk on fine motor scale and a 136% increased risk on problem solving scale at 2 months of age. Conclusion Inadequate responsive caregiving at 2 months of age significantly stunted gross motor, fine motor, problem solving, and personal-social development of 2-month-old infants, and the negative impact on personal-social scale may continue to 6 months of age.

Key words: responsive caregiving, early childhood development, birth cohort study