Recovery in Young Children with Weight Faltering: Child and Household Risk Factors.
Recovery in Young Children with Weight Faltering: Child and Household Risk Factors.
复制标题
体重摇摇欲坠的幼儿的康复：儿童和家庭风险因素。
DOI：
10.1016/j.jpeds.2015.11.007
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Feigelman,Susan
中科院分区：
文献类型：
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作者：
Black,MaureenM;Tilton,Nicholas;Bento,Samantha;Cureton,Pamela;Feigelman,Susan
目的探讨体重不稳儿童体重恢复是否因入组年龄、儿童及家庭危险因素而异。研究设计：观察性的，在跨学科的专业实践中进行了技能培养用餐时间行为干预，包括用视频录制的互动指导。年龄6-36月龄，体重/年龄<第5百分位或两个主要百分位的交叉。儿童分为<24个月和≥24个月。儿童和家庭风险因素被总结为风险指数（上四分位数=高风险，相对于参考值）。结果是6个月内体重/年龄z分数的变化。采用纵向线性混合效应模型进行分析，包括年龄与风险指数相互作用项。结果纳入286例儿童，平均年龄18.8个月，SD 6.8。不论风险指数或年龄，体重/年龄均显著恢复。平均体重/年龄z分数变化在年轻人中显著大于老年人（0.29 vs 0.17，P= .03）；最高家庭风险四分位数与参考比较（0.34 vs 0.22，P= 0.046）；与参考文献相比，高危儿童四分位数略高（0.37 vs 0.25，P= 0.058）。平均体重/年龄z分数变化与单一危险因素或相互作用无关；体重增加最多的是体重过轻的儿童。结论6个月后体重恢复虽不明显，但在年龄较小的儿童和有多种儿童及家庭危险因素的儿童中更为显著。研究结果支持差异易感性理论，即一些具有多种危险因素的儿童对干预的反应不同。未来的调查应评估进餐时间行为干预的组成部分。
ObjectiveTo examine whether weight recovery among children with weight faltering varied by enrollment age and child and household risk factors.Study designObservational, conducted in an interdisciplinary specialty practice with a skill-building mealtime behavior intervention, including coaching with video-recorded interactions. Eligibility included age 6-36 months with weight/age <fifth percentile or crossing of 2 major percentiles. Children were categorized as <24 months vs ≥24 months. Child and household risk factors were summed into risk indices (top quartile = elevated risks, vs reference). Outcome was weight/age z-score change over 6 months. Analyses were conducted with longitudinal linear mixed-effects models, including age by risk index interaction terms.ResultsEnrolled 286 children (mean age 18.8 months, SD 6.8). Significant weight/age recovery occurred regardless of risk index or age. Mean weight/age z-score change was significantly greater among younger compared with older age (0.29 vs 0.17,P= .03); top household risk quartile compared with reference (0.34 vs 0.22,P= .046); and marginally greater among top child risk quartile compared with reference (0.37 vs 0.25,P= .058). Mean weight/age z-score change was not associated with single risk factors or interactions; greatest weight gain occurred in most underweight children.ConclusionsWeight recovery over 6 months was statistically significant, although modest, and greater among younger children and among children with multiple child and household risk factors. Findings support differential susceptibility theory, whereby some children with multiple risk factors are differentially responsive to intervention. Future investigations should evaluate components of the mealtime behavior intervention.