Determinants of developmental coordination disorder in 7-year-old children: a study of children in the Danish National Birth Cohort
Determinants of developmental coordination disorder in 7-year-old children: a study of children in the Danish National Birth Cohort
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DOI：
10.1111/dmcn.12223
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发表时间：
2013-11-01
影响因子：
3.8
通讯作者：
Andersen, Anne-Marie Nybo
中科院分区：
文献类型：
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作者：
Larsen, Rikke Faebo;Mortensen, Laust Hvas;Andersen, Anne-Marie Nybo
目的探讨7岁儿童发育性协调障碍的早期生活决定因素。方法本研究基于丹麦国家出生队列7年跟踪研究的33354名妇女及其子女的数据。关于几个潜在决定因素(怀孕时的母亲年龄、母亲的职业状况、怀孕期间吸烟和饮酒、儿童性别、宫内发育受限、早产程度和走路年龄)的信息是从人口登记、怀孕期间和孩子18个月大时的访谈中获得的。这项研究的结果是7岁时的DCD，由经过验证的发展协调障碍问卷衡量。结果研究人群中男性17065人，女性16289人(极早产[23(+0)~31(+6)周]141例(0.4%)；中度早产[32(+0)~36(+6)周]1281例(3.8%)；足月出生[37(+0)~41(+6)周]29044例(87.1%)；以下因素是DCD的独立预测因素：女性(优势比[OR]0.36[95%可信区间(CI)0.31-0.41])；极早产(OR 6.28[95%CI 3.99-9.89])或中度早产(OR 2.10[95%CI 1.65-2.67])；胎龄小(OR 1.74[95%CI 1.46-2.08])；年龄15个月或以上，达到行走能力(OR 3.05[95%CI 2.57-3.60])；母亲职业地位(高级专业人员(OR 1.28[95%CI 1.02-1.61)；不从事经济活动(OR 1.43[95%CI 1.07-1.91])。母亲年龄小、吸烟是足月儿发生DCD的危险因素，说明DCD的危险性随胎龄降低而增加。胎儿宫内发育受限也是一个很大的危险因素，走路迟缓也是一个危险因素。
AimThe aim of this study was to investigate early life determinants of developmental coordination disorder (DCD) in 7-year-old children.MethodThe study was based on data from 33354 women and their children who participated in the 7-year follow-up study of the Danish National Birth Cohort. Information on several potential determinants (maternal age at conception, maternal occupational status, smoking and alcohol consumption during pregnancy, child's sex, intrauterine growth restriction, degree of preterm birth, and age at walking) was obtained from population registries, from interviews during pregnancy and when the child was 18months old. The outcome in this study was DCD at 7years of age, measured by the validated Developmental Coordination Disorder Questionnaire. The associations between the potential determinants and DCD were estimated using logistic regression.ResultsThe study population consisted of 17065 males and 16289 females (141 [0.4%] born very preterm [23(+0)-31(+6)wk]; 1281 [3.8%] born moderately preterm [32(+0)-36(+6)wk]; 29044 [87.1%] were born term [37(+0)-41(+6)wk], and 2888 [8.7%] were born post-term [42(+0)wk]). Independently of each other, the following determinants were predictors of DCD: being a female (odds ratio [OR] 0.36 [95% confidence interval {CI} 0.31-0.41]); being born very preterm (OR 6.28 [95% CI 3.99-9.89]) or moderately preterm (OR 2.10 [95% CI 1.65-2.67]); being small for gestational age (OR 1.74 [95% CI 1.46-2.08]); being 15months of age or more at walking attainment (OR 3.05 [95% CI 2.57-3.60]); and maternal occupational status (higher grade professionals (OR 1.28 [95% CI 1.02-1.61); economically inactive (OR 1.43 [95% CI 1.07-1.91]). Young maternal age and smoking were risk factors among term-born children.InterpretationThe risk of DCD increases with decreasing gestational age. Intrauterine growth restriction is also a strong risk factor, as well as delayed walking.