Table of Content

10 June 2021, Volume 29 Issue 6

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Professional Forum

Revisiting of scientific assessment of child growth and development

LI Hui

2021, 29(6):  581-583.  DOI: 10.11852/zgetbjzz2021-0771

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Growth and development evaluation is the basis of practice for child health care and pediatric clinic. By gaining access to the growth, nutrition and health information, growth assessment can help facilitate the early detection of abnormalities, assist in the disease diagnosis, and evaluate the efficacy of treatment. Accurate assessment requires suitable evaluation method, properly defined criteria, precise measurement, as well as rigorous data analysis. With multiple growth indicators integrated together, the growth chart has proved itself to be the most effective clinical technique to conduct children growth assessment and tracking.

Original Articles

Effect of parental height on the height of children under 7 years old

ZHANG Ya-qin, LI Hui, WU Hua-hong, ZONG Xin-nan

2021, 29(6):  584-588.  DOI: 10.11852/zgetbjzz2021-0623

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Objective To analyze the effect of parental height on the height of children under 7 years old, in order to provide evidence for individual growth evaluation. Methods A total of 161 297 children with completed parental height information, who were from The National Survey on Physical Growth and Development of Children Under 7 Years in The Nine Cities in 2015, were analyzed.The Z-scores of children's height, father's height, mother's height, and mid-parental height were calculated.The Spearman method was used to analyze the correlation between children's height and father's height, mother's height and mid-parental height.All the children were divided into 6 groups according to their mid-parental height and their differences of children's height in each group were compared. Results 1) Children's height was positively correlated with father's height, mother's height and mid-parental height(r=0.13—0.42, P<0.05), and the correlation coefficient with mid-parental height was the highest.2) According to their mid-parental height, the children were divided into six groups:short stature, slightly short stature, low-medium stature, upper-medium stature, slightly tall stature and tall stature.The average height of children in each group increased sequentially from parental short stature to parental tall stature.The children's height in the parental short stature group was 1.9—14.7 cm lower than that in the parental tall stature group, and the differences increased with age.3) The third percentile (P₃) of children's height in the parental slightly short stature group was 0.6—4.8 cm lower than that the P₃ of Chinese children's height standards, while the P₃ of children's height in the parental slight tall stature group was 0.6—4.7 cm higher than that of the height standards.4) The average differences between the children's height Z score and the mid-parental height Z score in the parental short stature, parental slightly short stature, parental low-medium stature, parental upper-medium stature, parental slightly tall stature and parental tall stature group were 1.27±0.99, 0.61±0.92, 0.18±0.89,-0.19±0.90,-0.61±0.93, and-1.17±0.92, respectively. Conclusions The height of children under 7 years old is positively correlated with their parental height.The height of children with parental short stature is lower than that of children with parental tall stature, and the children's height are higher than the genetic height of the family among the children with parental short stature, which suggested that the influence of parental height should not be ignored when evaluating and explaining the height of individual children.

Study on dietary behavior and physical growth of preschool children in nine cities of China

WU Hua-hong, LI Hui, ZONG Xin-nan, ZHANG Ya-qin

2021, 29(6):  589-593.  DOI: 10.11852/zgetbjzz2021-0622

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Objective To know about the dietary status of preschool children in nine cities of China, and to analyze the influence of different dietary behaviors on children's physical growth, so as to provide evidence for the targeted intervention. Methods A cross-sectional study was conducted in nine cities of China from June to October in 2015, including Beijing, Harbin, Xi'an, Wuhan, Nanjing, Shanghai, Guangzhou, Fuzhou and Kunming.A stratified cluster sampling method was used to select 53 155 children aged 3-7 years.The physical measurement was completed by uniform trained personnel and uniform measurement tools on site.The dietary behaviors were collected by self-designed questionnaire.The differences of physical growth between different dietary behaviors groups were compared, and the main factors affecting physical growth was determined by multiple Logistic regression analysis. Results 1) Among preschool children in nine cities, 34.0% were picky eaters; the percentage of drinking milk and eating eggs was 96.0% and 96.2%, respectively, and 54.3% drank milk and 30.6% ate eggs every day.2) The growth level of picky eaters was lower than non-picky eaters, the height SDSand weight SDS of picky eaters were 0.01±1.00 and 0.10±1.10, and those of non-picky eaters were 0.17±1.01 and 0.17±1.15.Moreover, among picky eater, the growth level of those who did not like meat, eggs was significantly lower than that of other groups (P<0.01).3) The growth level of children with high frequency of milk and eggs intake was higher than other groups.The height SDS and weight SDS of children who ate more than 6 eggs per week were 0.26±0.99 and 0.25±1.13, which were -0.12±1.02 and -0.20±1.10 for those who did not eat eggs.The height SDS and weight SDS of children who drank more than 6 packets of milk per week were 0.17±1.01 and 0.14±1.14, which were -0.14±1.04 and -0.21±1.15 for those who did not drink milk(P<0.01).4) Multivariate analysis showed that non-picky eating behavior was a favorable factor for children's growth level, while lower frequency of milk and eggs intake and picky eaters did not like meat, eggs and fish were the unfavorable factors for children's growth level. Conclusions The proportion of eggs and milk intake in preschool children has increased.Non-picky eating behavior, regular and adequate intake of meat, eggs and milk are favorable factors for children's physical growth.

Birth cohort study on the effects of complementary feeding on body mass index growth trajectories from birth to 24 months in rural Western China

ZHOU Jing, ZENG Ling-xia, MI Bai-bing, PEI Lei-lei, YAN Hong

2021, 29(6):  594-599.  DOI: 10.11852/zgetbjzz2020-2060

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Objective To describe the body mass index(BMI) growth trajectories from birth to 24 months old, and to examine the effect of time and quality of complementary feeding on the BMI growth trajectories. Methods A total of 1 388 eligible births were followed up from birth to 24 months old. Height and weight were measured at birth, 3, 6, 9, 12, 18 and 24 months old. The demographic data, feeding, activity and diseases data were also collected prospectively. Latent growth mixture modeling method was used to model the BMI growth trajectories. Mixed-effects Logistic regression analysis was used to examine the effect of time and quality of complementary feeding on BMI growth trajectories. Results Finally 1 255 (90.4%) children were available for study. Six BMI trajectory patterns were identified and labeled as follows:normative growth (6.5%), normal-accelerating growth (4.8%), normal-decelerating growth (28.0%), lower-persistent growth (32.9%),rapid growth (17.8%), and rapid-accelerating growth (10.0%). Taking normative growth group as reference, multivariate Logistic regression analysis indicated that introduction of complementary feeding before 6 months old could significantly increase the risk of rapid growth (OR=2.16, 95%CI:1.01-4.83) and rapid-accelerating growth (OR=3.13, 95%CI :1.35-7.25). After adjusting for confounding factors, the relationship remained significant (aOR=2.41,95%CI:1.03-5.63;aOR=3.46,95%CI:1.41-8.48). The lower feeding index score at 1 year old might significantly increase the risk of rapid growth (OR=2.50,95%CI: 1.23-5.05). This association persisted after adjustment for confounding factors (OR=2.35,95%CI:1.10-5.07). Conclusions In study area, the main BMI growth trajectory patterns include normal-decelerating growth, lower-persistent growth and rapid growth. The time and quality of complementary feeding may influence the excess weight gain during infancy.

Moderating effect of children's temperament on the relationships between parental feeding practices and their preschoolers' picky eating

WANG Jian, WU Ru-xing, CHENG Xu-wen, WU Ying-hui, CHEN Ru-nan, CHEN Jin-jin, ZHU Da-qiao

2021, 29(6):  600-604.  DOI: 10.11852/zgetbjzz2021-0061

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Objective To explore the relationships between parental feeding practices and children's picky eating,and to test the moderating effects of children's temperament between them. Methods A cross-sectional survey was conducted in a convenient sample of 442 parents with their preschool children aged 3—6 years in Pudong New District of Shanghai in June 2020. The questionnaire consisted of the Chinese Preschoolers' Caregivers' Feeding Behavior Scale,Child Feeding Questionnaire,Chinese Preschoolers' Eating Behavior Questionnaire and Childhood Behavior Questionnaire. Results Parental encouragement of healthy eating was negatively associated with children's picky eating(β=-0.270,P＜0.001),and parental use food as a reward was positively associated with children's picky eating(β=0.210,P＜0.001). Children's anger/frustration was found to significantly moderate the relationship between parental encouragement of healthy eating and children's picky eating(β=0.125,t=2.207,P＜0.05),as well as the relationship between using food as a reward and children's picky eating(β=0.141,t=3.465,P＜0.001). The moderating effect of children's inhibitory control was not statistically significant. Conclusions The relationships between parental feeding practices(encouragement of healthy eating and using food as a reward) and children's picky eating are moderated by children's negative emotion(anger/frustration). Thus,parents should take children's negative emotion into consideration and adopt suitable feeding practices,such as encouragement of healthy eating instead of using food as a reward,so as to reduce the likelihood of children's picky eating.

Interaction between outdoor physical activity and taking extra-curricular cultural classes before school age on poor vision of primary and middle school students

XIE Ming, ZENG Yuan, YUAN Shu-qian, LIU Yin-yue, CHEN Yan-hua, HU Ji, ZHENG Chan-juan, WANG Fei, YANG Yi-de

2021, 29(6):  605-608.  DOI: 10.11852/zgetbjzz2020-2080

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Objective To demonstrate the interaction effect of outdoor physical activity and extra-curricular cultural classes before primary school on poor vision of primary and middle school students, so as to provide scientific basis for formulating strategies and measures to prevent and control poor vision of primary and secondary school students. Methods A stratified cluster random sampling method was used for cross-sectional study from September to November 2018. A total of 8 467 students from fourth grade to senior three grade in Hunan Province completed the physical examination and questionnaire survey.Multivariate Logistic regression was used to explore the interactive effect of outdoor physical activity and extra-curricular cultural class before primary school on poor vision, also relative excess risk of interaction (RERI), attributable proportion of interaction (API), interaction index S (Index S) were calculated to demonstrate the interaction. Results Among the 8 467 subjects, 5 612(66.28%) children had poor vision. Compared with those who did not attend extra-curricular cultural classes, those who attended had a significantly higher risk of poor vision (OR=1.500, 95%CI:1.331—1.689, P<0.001). Compared with those whose outdoor physical activity ≥ 2 h/day, those whose outdoor physical activity < 2 h/day had a significantly higher risk of poor vision (OR=1.247, 95%CI:1.103—1.409, P<0.001). There was a significant interaction between outdoor physical activity and extra-curricular cultural classes before primary school on poor vision (P_interaction=0.003). With the potential covariates adjusted, the values of indicators (RERI, API, Index S) for interaction between outdoor physical activity and taking extra-curricular cultural classes before school age were 0.529, 0.310 and 3.973, respectively. Conclusions Both outdoor physical activities and extra-curricular cultural classes before primary school are associated with poor vision. In addition, they have an interactive effect on poor vision. Therefore, it is supposed to do more outdoor activities for preschoolchildren thereby reducing the prevalence of poor vision.

Correlation analysis of hyperuricemia with dietary vitamin D intake inmale youngsters

ZHANG Gao-zhi, ZHANG Li-yong, NAN Zhi-cheng, ZANG Xun-xiong, WANG Jun, LIN Xue-feng

2021, 29(6):  609-613.  DOI: 10.11852/zgetbjzz2021-0014

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Objective To analyze the correlations of hyperuricemia (HU) with dietary vitamin D intake in male youngsters, in order to provide new preventive method to male youngsters with HU. Methods Totally 800 male youngsters undergoing health examination in Yueqing People's Hospital Affiliated to Wenzhou Medical University from January 2019 to October 2020 were enrolled into this study and were divided into study group(HU group,n=380) and control group(n=420) according to the serum level of uric acid. The serum levels of vitamin 25(OH)D₃, TC, HDL-C, LDL-C, TG, fasting blood-glucose (FBG), calcium and phosphate were detected and compared between the two groups. The dietary vitamin D intake was assessed using a validated semi-quantitative food frequency questionnaire and compared between the two groups. The correlations of the serum levels of uric acid with the serum levels of vitamin 25(OH)D₃ and the dietary vitamin D intake were confirmed by Pearson linear correlation analysis. The risk factors of HU to the above indexes were confirmed by multivariate Logistic analysis. The diagnostic value of the dietary vitamin D intake to the HU of the male youngsters was analyzed by receiver operating characteristic curves (ROC). Results Compared with control group, the serum levels of vitamin 25(OH)D₃, HDL-C and the dietary vitamin D intake of the study group were significantly lower (t=4.863, 23.791, 12.347, P<0.05), while the serum levels of LDL-C and TC of the study group were higher (t=10.606, 12.090, P<0.05). But there were no significant difference on the serum levels of TG, FBG, calcium and phosphate between the two groups (P>0.05). The negative correlations of the serum levels of uric acid with serum levels of vitamin 25(OH)D₃ (r=-0.803, P=0.024) and the dietary vitamin D intake (r=-0.726, P=0.031) were found. Multivariate Logistic analysis showed that the higher serum levels of vitamin 25(OH)D₃ and the higher dietary vitamin D intake were independent protective factors for HU in male youngsters (OR=0.465, 0.245, P<0.05). When the cut-off point of the dietary vitamin D intake was 4.8 μg/d, the AUC of predictions to the HU in male youngsters was 0.816 and the sensitivity was 88.4% and specificity was 92.3%. Conclusions Dietary vitamin D intake and the serum levels of vitamin 25(OH)D₃ are negatively associated with HU in male youngsters. The male youngsters with HU should enhance the dietary vitamin D intake and improve the serum levels of vitamin 25(OH)D₃.

Research on emotional and behavioral problems of older children fromthe perspective of family ecosystem

JIN Meng, YANG Si-yu, TIAN Pu, HUANG Ya-qin, ZHOU Le-shan

2021, 29(6):  614-618.  DOI: 10.11852/zgetbjzz2020-1788

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Objective To study the emotional and behavioral problems of older children in two-child families, and to analyze the influencing factors within the family ecosystem. Methods From April to July, 2020, 538 older children in Shangqiu city, Henan Province were selected as the participants. The Strengths and Difficulties Questionnaire (SDQ), Children's Parenting Style Questionnaire and Family Intimacy and Adaptability Scale were used to conduct the survey. Results The abnormal detection rate of emotional and behavioral difficulties was 15.1% (81/538). Multivariate Logistic regression analysis showed that the age gap of 8 to 13 years old (OR=2.406, 95%CI:1.159-4.995), competitive sibling relationship (OR=4.773, 95%CI:1.933-11.785), overprotection of parents (OR=2.821, 95%CI:1.076-7.392)/(OR=4.113,95%CI:1.903-8.890), fathers' rejection (OR=3.215, 95%CI:1.324-7.807), and regular families (OR=4.055, 95%CI:1.312-12.533) significantly increased the risk of emotional and behavioral problems in middle and older children. Compared with temperament of depression, the risk of emotional and behavioral problems in the children of other temperament types was significantly reduced (OR=0.227, 0.228, 0.230, 95%CI:0.073-0.707, 0.069-0.754, 0.071-0.744). And the risk of emotional and behavioral problems in the children of other high-income families was significantly reduced (OR=0.272, 0.334, 0.133, 0.228, 95%CI:0.095-0.778, 0.119-0.939, 0.035-0.501,0.056-0.924) compared with the children in low-income families (monthly income < 2 000 yuan). Conclusions The emotional and behavioral problems of the older children in the two-child family are more prevalent than those of the children and adolescents at the same time. Therefore, attention should be paid to the older children in the two-child family, and targeted interventions should be conducted according to different characteristics of individuals.

Review

Research progress on catch-up growth of small for gestational age

CHEN Zhu-xiu, LI Xiao-nan

2021, 29(6):  619-622.  DOI: 10.11852/zgetbjzz2020-1603

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Small-for-gestational-age infants will experience catch-up growth after they survive and escape from the bad uterine environment. Catch-up growth is beneficial to improve short-term survival rate,improve adult height and later cognition in children.However,excessive catch-up may have adverse effects on cardiovascular and metabolic health. This article mainly introduces the definition and current situation of catch-up growth,the influencing factors and possible advantages and disadvantages of catch-up growth,and provides an outlook to future research directions of catch-up growth.

Research progress on applied behavioral analysis intervention in autism spectrum disorders

DAI Zhen-zhen, JIANG Zhi-mei, ZHU Jun-li

2021, 29(6):  623-626.  DOI: 10.11852/zgetbjzz2020-0350

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder found in early childhood,mainly characterized by social disorder,stereotyped behaviors and restricted interests,all of which limit and impair children's daily life functions.In recent years,there are more and more kinds of interventions for ASD,and applied behavior analysis (ABA) is currently the only form of treatment for ASD endorsed by the US Surgeon General.Its effectiveness has been proven and it is now widely used in the treatment of ASD children.This paper reviews the basic theory,function and effect of ABA compared with other intervention methods.

Recent research advances on obesity-associated inflammation

HU Jun-long, LIU Zheng-juan

2021, 29(6):  627-631.  DOI: 10.11852/zgetbjzz2020-1128

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Obesity, a risk factor for several chronic diseases, has become a major global health problem. The study on the pathogenesis of obesity has been a focus currently, and multiple researches have revealed that obese individuals are under the status of chronic inflammation. In this review, the pathogenesis of obesity-associated inflammation will be summarized.

Sluggish cognitive tempo in attention deficit and hyperactivity disorder

JIANG Wen-qing, DU Ya-song

2021, 29(6):  632-635.  DOI: 10.11852/zgetbjzz2020-0257

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Sluggish cognitive tempo (SCT) is a highly correlated and independent trait of attention deficit hyperactivity disorder (ADHD).It is worthy of clinical attention when ADHD children comorbid with SCT,which shows its special feature in clinical manifestation and treatment method.This article reviews the historical relationship between SCT and ADHD,clinical characteristics,evaluation methods,therapeutic effectiveness and outcome of the condition when SCT comorbid with ADHD.

Review of relation between children's narrative and reading comprehension

SUN Yi-tong, LI Su

2021, 29(6):  636-640.  DOI: 10.11852/zgetbjzz2020-1425

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Narrative is an important aspect of children's language development. It plays an important role in children's academic learning, especially in reading comprehension. The current review combs the research methods in examining relationship between children's narrative and their reading comprehension, and summarizes the findings in previous studies. Moreover, the studies on improving reading comprehension through narrative intervention are reviewed, thereby discussing future directions of enhancing children's reading comprehension through narrative.

Research advances on working memory training for children with attentiondeficit hyperactivity disorder

LI Yan, JIANG Wen-qing, QIAN Yun, DU Ya-song

2021, 29(6):  641-644.  DOI: 10.11852/zgetbjzz2020-1194

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Children with attention deficit hyperactivity disorder (ADHD) have extensive and obvious working memory deficits, which affect their symptom development and performance in reasoning, organizational planning, selective attention, and other aspects. Therefore, the training of working memory is of substantial significance for ADHD children. This review focuses on the domestic and foreign studies of working memory training in recent years, summarizes its theoretical basis, executive function and behavioral efficacy, and reviews the limitations.

Meta Analysis

Meta-analysis on psychological sub-health status among adolescents in China

SU Xian-biao, YIN Ai-hua, YANG Ying, WU Shu-xin, LIU Jin-tong, WANG Yang, WANG Wei

2021, 29(6):  645-649.  DOI: 10.11852/zgetbjzz2020-1448

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Objective To estimate the epidemiology and distribution characteristics of psychological sub-health status among adolescents in China, in order to provide reference for knowing about the psychological status of adolescents. Methods Databases at home and abroad were searched to collect literatures on psychological sub-health among adolescents in China published from January 2008 to March 2020. Random-effects model was adopted to analyze the overall detection rate of psychological sub-health status, and subgroup analysis was used to analyze the differences in different gender, grade, region and period groups. Results A total of 17 studies with samples of 63 060 individuals were included. The report rate of psychological sub-health status was 15.50% (95%CI:13.04%—18.31%).Subgroup analysis showed that the report rates of psychological sub-health status among adolescents in junior high school students, senior high school students and college students were 14.03%, 18.99% and 9.52%, respectively. And the report rate of psychological sub-health status was highest in during 2016 to 2020 (16.75%), followed by the year 2011—2015 (16.38%), and 2008—2010(11.46%). Conclusion Psychological sub-health status is common among adolescents in China, and its detection rate has significant differences in different grade and year groups.

Clinical Research

Development and evaluation of Infant Eating Behavior Scale

YIN Ke, ZHANG Ting, SONG Zhi-xiao, ZHANG Li, QIAO Xiu-yun, LI Yan

2021, 29(6):  650-654.  DOI: 10.11852/zgetbjzz2020-2099LA

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Objective To develop Eating Behavior Scale for infants with high reliability and validity,so as to provide a scientific and reliable tool for the evaluation of infants' eating behavior in China. Methods A total of 281 parents of 6- to 11-month-old infants were investigated. Then the initial questionnaires were formed. Factor analysis,discriminant analysis,Cronbach's α coefficient and Spearman correlation analysis were used to screen the initial items. And 935 parents of 6- to 11-month-old infants were asked to fill out primary questionnaire. Finally the formal questionnaire was formed. The reliability and validity of the formal questionnaire was tested by Guttman split-half reliability analysis,retest reliability analysis,exploratory factor analysis and confirmatory factor analysis. Results 1) Finally the Eating Behavior Scale of 6- to 11-month-old infants consisted of 33 items with 6 dimensions was formulated. The Cronbach's α coefficient of scale was 0.910,Guttman split-half reliability was 0.927,the retest reliability of the scale was 0.693,and the correlation coefficient between each factor and the scale ranged from 0.266 to 0.752. Confirmatory factor analysis showed that the values of χ²/df,GFI,CFI,RFI and RMSEA of the scale were 3.180,0.831,0.842,0.766 and 0.068,respectively. 2) The length and weight of infants were positively correlated with the birth weight,of food type and eating ability,of feeding behavior and of food response(P＜0.05). The education level of parents and income had significant influences on infants' eating behaviors(P＜0.05). Conclusion The scale is a scientific and reliable tool with good reliability and validity,which can objectively evaluate the dietary behavior problems of infants in China.

Trend analysis of height for age Z score of Chinese children under 5 years old in 2002 and 2013

WANG Shu-xia, YANG Zhen-yu, WANG Jie, DUAN Yi-fan, PANG Xue-hong, LAI Jian-qiang

2021, 29(6):  655-659.  DOI: 10.11852/zgetbjzz2020-1981

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Objective To analyze the trend of height(length) for age Z score [HAZ(LAZ)] of Chinese children under 5 years old in 2002 and 2013, so as to provide scientific evidence for determining critical window period for improving stunting. Methods Data were extracted from Chinese national nutrition and health survey in 2002 and Chinese National Nutrition and Health Surveillance in 2013. Two-sample t-test was used to analyze the difference of HAZ(LAZ) between 2002 and 2013, and restricted cubic spline regression was used to analyze the trend of HAZ(LAZ) of Chinese children under 5 years old in 2002 and 2013. Results The HAZ(LAZ) were-0.31±1.54 and 0.03±1.36 in 2002 and 2013, respectively, and the difference was significant(t=-23.72, P<0.001). The differences of HAZ(LAZ) were significant between 2002 and 2013 in 0—1 month,6—23 months and 24—59 months groups(t=2.68,-11.21,-18.69,P<0.01). In 2002, the HAZ (LAZ) of children under 5 years old fell to the trough firstly, and then increased slowly. In 2013, the HAZ(LAZ) of children under 5 years old reached the peak firstly, and then declined, especially among 6—23 months. Conclusions Compared with 2002, the HAZ (LAZ) values of Chinese children under 5 years old increase significantly in 2013. And 6 to 23 months old is the critical window for stunting intervention because of the continuously downward trend.

Dynamic analysis of growth retardation and the severity of bronchopulmonary dysplasia

XU Ru-zheng, SUN Bin

2021, 29(6):  660-664.  DOI: 10.11852/zgetbjzz2020-2059

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Objective To dynamically monitor the increase of body weight, body length and head circumference of children from birth to discharge, and to analyze the correlation between growth retardation and severity of bronchopulmonary dysplasia(BPD)in different periods, so as to provide reference for clinical diagnosis and treatment of BPD. Method The data of body weight, body length, head circumference, gestational age and oxygen therapy were collected from 167 infants admitted to the NICU of Children's Hospital of Suchou University from January 1st, 2016 to December 31st, 2019 who were diagnosed with BPD within 24 hours after birth. Results A total of 159 children with BPD met the inclusion criteria, including 79 cases with mild BPD, 52 cases with moderate BPD, and 28 cases with severe BPD. There were significant differences on birth weight, male infants, antenatal corticosteroids, mechanical ventilation, oxygen therapy duration among children in different severity groups(χ²=13.958, 7.451, 11.287, 14.346, Z=14.750,P<0.05 or <0.01). There were significant difference on body weight, length and head circumference between children with or without growth retardation (H_weight=-5.429, H_length=-9.632, H_{head circumference}=-9.632, all P＜0.001). And the differences were significant between the two groups on the 28th days after birth (H_weight=-6.726, H_length=-6.254, H_{head circumference}=-6.254, all P<0.001) and at corrected gestational age of 36 weeks (H_weight=-7.091,H_length=-7.178, H_{head circumference}=-7.178, all P<0.001). Conclusions Growth retardation of body weight and length may be related to the severity of BPD. In clinical practice, preterm infants should be given reasonable nutrition in order to promote uniform growth.

Growth and development status of preschool children in Shijiazhuang area and the related influencing factors

FAN Li-xin, YU Ran, CAO Zhen-zhen, MA Jing-ru

2021, 29(6):  665-668.  DOI: 10.11852/zgetbjzz2020-1946

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Objective To understand the growth and development of 3- to 6-year-old preschool children in Shijiazhuang area, and to explore its influencing factors. Methods The physical examination data of preschool children in various districts and counties of Shijiazhuang from 2018 to 2019 were collected. The physical development and growth standards of children in nine major cities in China in 2005 were used as reference values to evaluate the height and weight development of preschool children. Results 1) A total of 49 644 preschool children with valid data on physical examination were enrolled in this study, including 25 885 boys (52.1%) and 23 759 girls (47.9%).2) Among them, 1 212 (2.4%) were underweight children(＜P₃), 5 353 (10.8%) were overweight(＞P₉₇), 1 497 (3.0%) were too short(＜P₃), and 6 876(13.9%) were overheight (＞P₉₇). 3) Inconsistent ABO blood type between mother and child (OR=0.671, 95%CI:0.481—0.935,P=0.019), low birth weight(OR=0.546,95%CI:0.443—0.674,P<0.001), low birth height(OR=0.335,95% CI:0.272—0.414,P<0.001) were independent related factors for preschool children with short stature. Children who were too short at birth (OR=0.330,95%CI:0.269—0.404,P<0.001) and underweight ( OR=0.330,95%CI:0.269—0.404,P<0.001) were related factors for underweight in preschool children. Conclusions Compared with the standards of the nine cities in 2005, the growth and development of 3- to 6-year-old preschool children in Shijiazhuang area is higher than the average level of preschool children in other cities across the country. The height and weight development of preschool children are affected by the height and weight at birth. Attention should be paid to the three-level prevention of the growth and development of preschool children and the management of high-risk factors during pregnancy and childbirth.

Prevalence and risk factors of nonalcoholic fatty liver disease among obesity children aged 7 to 14 years in Tangshan city

CHEN Xin-chun, KOU Yong-mei, LIU Xiao-lu, Li Dan, YANG Xue-bing

2021, 29(6):  669-673.  DOI: 10.11852/zgetbjzz2020-1489

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Objective To investigate the epidemiological characteristics and risk factors of nonalcoholic fatty liver disease (NAFLD) in obesity children in Tangshan,in order to provide reference for the early intervention. Methods Obesity children screened by physical examination of school-age children in Tangshan City from 2018 to 2019 were the study objects. The prevalence of NAFLD was described by age,and indicators were compared between NAFLD group and non-NAFLD group to analyze the risk factors of NAFLD,including metabolic syndrome (MetS),body mass index (BMI),waist circumference(WC),waist-to-height ration(WHtR),transaminase,uric acid(UA),glucose and lipid metabolism index. Results 1) The prevalence of NAFLD in obesity children in Tangshan was 34.62%,and there was no significant difference between boys and girls (χ²=0.009,P=1.000). The prevalence of NAFLD increased with age (r=0.425,P＜0.001). 2) The prevalence rate of lipid metabolism disorder in 7- to 9-year-old children and 10- to 14-year-old children,and the prevalence rate of hypertension,MetS in 10- to 14-year-old children in NAFLD group were significantly higher than those in non-NAFLD group(χ²=6.159,10.994,5.543,4.524,P＜0.05). 3) Multivariate Logistic regression analysis showed that the risk factors of NAFLD included older age,hyperuricemia(HUA),higher BMI,higher ALT(OR=3.91,2.09,1.07,1.04,P<0.05). Conclusions The overall prevalence rate of obese children in Tangshan is at a high level,and the prevalence rate of NAFLD increases with age. The onset of NAFLD in obese children is closely related to older age,HUA,higher BMI and ALT level.

Experience Exchange

Study on the correlation between overweight during pregnancy and dietarybehavior in childhood on children's weight

ZHONG Ai-jin, LIU Hui-lin, YANG Min, HE Mei-xiang

2021, 29(6):  674-677.  DOI: 10.11852/zgetbjzz2020-2052

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Objective To explore the effects of pre-pregnancy weight, weight gain during pregnancy, and childhood dietary behavior on children's weight, so as to provide a scientific basis for the management of children's weight. Methods A total of 512 parturients and 512 infants who were delivered in the obstetrics department of Taikang Xianlin Gulou Hospital, Nanjing University School of Medicine from January 2014 to December 2016 were selected. The data of mothers' pre-pregnancy body mass index (BMI) and weight gain during pregnancy were collected for statistical analysis. Children were followed up from December 2019 to March 2020. Their height and weight were measured, and eating behaviors were evaluated. The effects of pre-pregnancy weight, weight gain during pregnancy, and childhood dietary behaviors on children's weight were analyzed. Results Totally 12.70% of the 512 children aged 3 to 6 years old were detected with overweight/obese. Compared with normal weight children, children whose mothers were overweight/obese before pregnancy (10.51% vs.38.46%,χ^*＝37.512, P=0.001) and overweight during pregnancy were more likely to be overweight/obese(7.83% vs. 43.78%, χ²=75.201, P＝0.001). Also, poor eating habits, picky eating and satiety response scores were higher in overweight/obese children (P=0.001). Logistic regression analysis also showed that pre-pregnancy weight(OR=1.109,95%CI:1.025—1.213), weight gain during pregnancy(OR=1.098, 95%CI:1.031—1.261) and dietary behavior in childhood including poor eating habits(OR=1.113, 95%CI:1.054—1.257), picky eating(OR=1.257, 95%CI:1.232—1.467), and satiety response(OR=1.284, 95%CI:1.135—1.513) significantly affected children's weight. Conclusions Children's weight could be affected by pre-pregnancy weight, weight gain during pregnancy and dietary behavior in childhood. Reasonable control of BMI before pregnancy and weight gain during pregnancy, and active guidance for children to establish healthy dietary behavior will help to reduce the incidence of overweight/obesity in children.

Analysis on the current situation of child rearing risks of 0- to 3-year-old children in Jiaxing City

ZHANGYing, LI Li, LI Jing, DING Jie, LIU Hui-juan, WANG Xiao

2021, 29(6):  678-681.  DOI: 10.11852/zgetbjzz2020-1796

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Objective To know about the current situation of child rearing risks for 0- to 3-year-old children in Jiaxing City as well as the existing problems in family rearing, so as to provide appropriate parenting suggestions for the families with children aged 0 to 3 years. Methods A cross-sectional survey method was used to select children aged 0 to 3 years who took physical examination at all child health clinics in Jiaxing City from June 1st to July 31st, 2020 into this study. Parents used their mobile phones to fill in the Nursing Risk Questionnaire for 0~6, 6~12,12~36 months old children and the self-designed Family Basic Circumstances Questionnaire online. Family intervention guide was given according to the risk factors. Results A total of 9 384 families with 0- to 3-year-old children were investigated. The positive rate of parenting risk screening was 30.48% for 0- to 6-month-old infants, 39.11% for 6- to 12-month-old infants, and 45.63% for 12- to 36-month-old children. The top three parenting risk factors for infants younger than 6 months old included having no breast milk (10.61%), less than 3 toys at home (8.34%), and at least 2 weeks of neonatal hospitalization (7.93%). The top three parenting risk factors for 6- to 12-month-old infants included not giving the iron-rich food (23.73%), nutritional disease (9.64%), and having milk less than 3 times a day (6.53%). The top three parenting risk factors for children aged 12 to 36 months were rarely having lean meat or eggs everyday (22.46%), no picture books at home (14.85%), and rarely playing with children everyday (9.87%). Multivariate Logistic regression analysis showed that the fathers with higher education level(high school or college, bachelor degree and above) (OR=0.784,95%CI:0.697—0.881; OR=0.701, 95%CI:0.599—0.820), mothers with higher education level (high school or college, bachelor degree and above) (OR=0.815, 95%CI:0.724—0.917; OR=0.628, 95%CI:0.539—0.732) were protective factors for positive parenting risk, while male children may have a higher risk for poor parenting(OR=1.160, 95%CI:1.066—1.262). Conclusion At this stage, infants and young children aged 0 to 3 are generally at risk of poor parenting. Professionals at all levels need to strengthen health education urgently, guide family scientific parenting, help to avoid avoidable risks in family parenting, thereby protecting the health of infants and young children physically and mentally.

Study on the relationship between caries and body mass index in childrenaged 3 to 5 years in Bianba County, Tibet

LIU Ke-liang, FU Xue-feng, HAO Xue-qi, WANG Yao-feng, SUN Lin-qing

2021, 29(6):  682-684.  DOI: 10.11852/zgetbjzz2020-1854

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Objective To investigate the relationship between the body mass index (BMI) and the decayed missing filled teeth (DMFT) of children aged 3 to 5 years in Bianba County, Tibet, so as to provide ideas for the development of preventive measures for children's dental health. Methods A total of 265 children aged 3 to 5 years,including 136 boys and 129 girls, were randomly selected from 11 township hospitals in Bianba County of Changdu city from May to August in 2019. A professional pediatrician who were professionally trained was selected to perform oral examination on the children using a uniform probe and mouthpiece and to record the number of missing teeth and calculate the DMFT index. Using the corrected height and weight measuring instrument, the height and weight of the children were measured in the same period, and the BMI was calculated. Statistical analysis was performed between the caries and BMI using SPSS 22.0 statistical software. Results There were statistically differences in BMI and DMFT of children among skinny,overweight,obese,control groups(F=14.824,P<0.001;H=33.125,P=0.002).The scatter plot analysis and Spearman correlation analysis showed that DMFT was negatively correlated with BMI(r_s=-0.68,P=0.001). Conclusions DMFT of 3- to 5-year-old children is closely related to BMI. Oral hygiene of children should be examined regularly to improve their quality of life.

Analysis of risk factors for bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome

DONG Meng-yuan, JI Ling, LIU Meng-meng, ZHU Xiao-fan, WANG Hui-juan

2021, 29(6):  685-688.  DOI: 10.11852/zgetbjzz2020-2150

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Objective To analyze the risk factors of bronchopulmonary dysplasia (BPD) in very low birth weight infants with neonatal respiratory distress syndrome (NRDS) and gestational age < 32 weeks,in order to provide reference for the prevention of BPD. Methods A total of 138 cases of preterm infants diagnosed with NRDS,with gestational age < 32 weeks and birth weight < 1 500 g,were enrolled into this study from October 2019 to July 2020 in the Neonatal Intensive Care Unit of the Third Affiliated Hospital of Zhengzhou University,and were divided into BPD group (n=32) and non-BPD group (n=106). Data on birth,treatment and pregnancy were collected and analyzed to determine the risk factors of BPD in these infants. Results Single factors analysis showed that there were significant differences in gestational age,birth weight,mechanical ventilation,glucocorticoids usage after birth,incidence rates of neonatal infection and prenatal infection between BPD group and non-BPD group (t=3.444,2.912,χ²=24.089,5.208,8.586,9.486,P＜0.05). Multivariate Logistic regression showed that gestational age ≥28 weeks was a protective factor for BPD(28—＜30 weeks OR=0.143,95%CI:0.035—0.579;30—＜32 weeks:OR=0.210,95%CI:0.047—0.939),while mechanical ventilation (OR=5.459,95%CI:1.991—14.963),neonatal infection (OR=4.075,95%CI:1.031—16.106) and prenatal infection(OR=3.375,95%CI:1.051—10.833)were independent risk factors of BPD (P<0.05). Conclusion Preventing infection,avoiding preterm delivery and reducing mechanical ventilation are important measures to reduce BPD in preterm infants diagnosed with NRDS,with gestational age < 32 weeks and birth weight < 1 500 g.

Appropriate Technology

Study on the family open oral food challenge in infants with non-IgE mediated cow'smilk protein allergy

XIONG Li-jing, HE Xiao-qing, LI Jing, LI Yang, YANG Wen-xu, LIU Li-rong, XIE Xiao-li

2021, 29(6):  689-693.  DOI: 10.11852/zgetbjzz2021-0357

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Objective To evaluate outcome interpretation of family open oral food challenge(OFC) utilized in infants who could not be confirmed by CMP-specific IgE and skin prick tests,in order to improve the accuracy of parent-reported symptoms. Methods A prospective study was conducted to enroll infants who took open OFCs from November 2018 to June 2019. The diagnosis efficiency and the accuracy of parent-reported symptoms were analyzed. Results A total of 162 infants received OFC for diagnosis,with an average age of(5.85±3.03)months old.While OFCs were conducted in 142 infants [(8.10±3.08) months old] for the judgment of oral tolerance.No episodes of anaphylaxis occurred in the process of challenge.Cutaneous and gastrointestinal symptoms were commonly reported on the first day of the test(77.78%) and the first week(79.58%).Kappa coefficient was 0.868(P＜0.001),suggesting good consistency of judgments between parents and specialists.The diagnosis accuracy of family open OFC tesx was 93.43%.The false-positive rate,false-negative rate,positive predictive value,negative predictive value was 9.15%,4.32%,90.85% and 95.68%,respectively.Vomiting was the most frequent reactions reported in false-positive cases.The amount of stimulation formula and the observation time were the important factors accounting for the false-negative results. Conclusions Family open OFC is an accurate and safe tool for assessing oral tolerance status in CMPA infants.The detailed instruction for parents and identification of the reproducibility could increase the safety and reliability of open OFC performing at home.