Abstract: Objective To explore the associated factors of anterior fontanelle delayed closure (AFDC) in infants and children under 3 years old,so as to provide evidence-based reference for diagnosis and treatment of delayed closure of AFDC. Methods Totally 61 infants with AFDC born from January 1st,2015 to December 31st,2015 and 183 infants with normal anterior fontanelle closure followed up for three years were enrolled in this study,variables such as birth weight,birth length,the size of anterior fontanelle at 1 month old,gender,mode of delivery,gestational age,fetus number,parity,the birth order,VA and VD average supplementation before two years old,the onset for adding complementary foods were compared between the two group. Results Univariate analysis showed that birth weight(χ²=8.309,P=0.016),the size of the anterior fontanelle at 1 month old (Z=-4.065,P＜0.001),VA average supplement before two years old (Z=-2.072,P=0.038) were associated with delayed anterior fontanelle closure in infants.Logistic regression showed the larger size of the anterior fontanelle at 1 month old (B=1.260,OR=3.526,P<0.001) was the main associated factors of delayed anterior fontanelle closure in infants,while perinatal and nutritional factors had no significant effect on the delayed closure of anterior fontanelle. Conclusions Delayed closure of anterior fontanelle is related to congenital enlargement of anterior fontanelle,and may be related to the nutritional status.But maternal perinatal status has no significant influence on the delayed closure of anterior fontanelle.

Key words: anterior fontanelle, delayed colsure, infants

摘要： 目的 分析影响婴幼儿前囟迟闭的影响因素,为儿童保健诊疗前囟迟闭婴幼儿提供循证依据。方法 选取2015年1月1日-12月31日出生并在四川大学华西第二医院儿童保健科连续随访3年的61例前囟迟闭婴幼儿为试验组,通过病例对照回顾性分析与183例前囟正常闭合婴幼儿在出生体重、出生身长、1月前囟大小、性别、生产方式、孕周、胎数、胎次、产次、2岁前维生素A平均补充量、2岁前维生素D平均补充量和辅食添加时间上的差异。结果 单因素分析显示出生体重(χ²=8.309,P=0.016)、1月龄前囟大小(Z=-4.065,P＜0.001)、2岁前VA平均补充量(Z=-2.072,P=0.038)与婴幼儿前囟迟闭发生有关;Logistic回归分析显示1月龄前囟偏大(B=1.260,OR=3.526,P<0.001)为婴幼儿前囟迟闭的主要影响因素;而围生期及营养因素在前囟迟闭发生上无显著影响。结论 0~3岁婴幼儿前囟迟闭的发生主要与先天性前囟较大有关,与营养状况有一定关系,但与孕母围生期因素无关。

关键词: 前囟, 延迟闭合, 婴幼儿