Objective: The aim of this study was to explore the relationship between breastfeeding duration and neurodevelopment in children aged 2 to 3 years in a Chinese population. Methods: This study was based on a cross-sectional survey. The data were from the National Nutrition and Health Systematic Survey for children in China which was conducted from 2019 to 2020. Characteristics of parents and children and the breastfeeding duration were obtained using interview-administered questionnaires. Children's neuropsychological development was assessed by a trained child health care physician using the Child Psychological Development Scale. A multivariable linear regression model was used to analyze the association between breastfeeding duration and neuropsychological development. Results: A total 1290 children aged 2-3 years were included in the present analysis. In multivariable linear regression models, after adjustment for potential confounders, children who were breastfed for 7-12 months had a 3.59-point increase in gross motor development ((3 = 3.59; 95% confidence interval [CI]: 1.23 to 6.34), a 3.73-point increase in fine motor development ((3 = 3.73; 95 % CI: 1.09 to 6.47), and a 2.87-point in language development ((3 = 2.87; 95 % CI: 1.12 to 5.31) compared with those who were never breastfed. Children who were breastfed for > 12 months had a 3.77-point increase in fine motor development ((3 = 3.77; 95 % CI: 0.98 to 6.86) compared with those who were never breastfed. Conclusions: Longer breastfeeding duration was associated with increased gross motor, fine motor, and language scores in our study population. Mothers in China should be encouraged to initiate and continue breastfeeding.

目的 了解0～23月龄婴幼儿大运动发育情况及其影响因素.方法 采用"儿心量表-Ⅱ"对全国20省市3 739名0～23月龄婴幼儿大运动发育商进行测查,同时采用问卷调查收集婴幼儿及其抚养人的相关信息.结果 出生体质量(β=-0.666,P=0.002)、主要抚养人(β=-0.395,P=0.000)、喂养方式(β=-0.250,P=0.011)、添加辅食(β=0.441,P=0.000)及家庭月均收入(β=0.189,P=0.005)与儿童大运动发育商的差异有统计学意义(P＜0.05).结论 低出生体质量不利于儿童大运动发育,母亲作为主要抚养人且家庭月均收入较高对孩子的大运动发育具有一定的促进作用.在喂养方面,坚持纯母乳喂养、适时添加辅食有助于大运动发育.

Objective The purpose of this survey was to explore the association of delivery mode with overweight and neurodevelopment of Chinese infants aged 1–5 months. Materials and methods This study was based on a cross-sectional survey. Data for this study were obtained from the Children’s Nutrition and Health System Survey in China which was conducted from 2019 to 2020. Characteristics of parents and children and the delivery mode were obtained using interview-administered questionnaires. Body mass index-for age z-score (BMI z) was calculated using World Health Organization (WHO) child growth standards. Children’s neurodevelopment was assessed by a trained child health care physician using the Child Psychological Development Scale. The association of delivery mode with infant overweight was analyzed using a multivariable logistic regression model. We conducted a multivariable linear regression model to explore the relationship between delivery modes with neurodevelopment. Results In total, the present analysis included 1,347 children aged 1–5 months, 35.61% were born via cesarean section, of which 15.21% were overweight. After adjustment for infant characteristics and parental factors, the cesarean section was significantly related with the likehood of being overweight [OR = 1.95; 95% confidence interval (CI): 1.27 to 2.98]. Children born via cesarean section had a 3.41-point decrease in gross motor development (β = −3.41; 95% CI: −5.77 to −1.05), a 3.65-point decrease in fine motor development (β = −3.65; 95% CI: −6.03 to −1.28), and a 2.96-point in language development (β = −2.96; 95% CI: −5.20 to −0.73), a 1.65-point in total development (β = −1.65; 95% CI: −3.17 to −0.14) compared with those who were vaginal birth. Conclusion In our study population, cesarean section was associated with overweight and neurodevelopment outcomes. The cesarean section might increase the likehood of infant overweight, and might decrease the developmental scores of gross motor, fine motor and language. Further studies should be conducted to verify the associations and explore the possible mechanisms.

目的 探讨母乳持续时间与学龄前儿童神经心理发育水平的相关性,为促进母乳喂养提供依据.方法 2019年9月—2021年5月选取北京市东城区、吉林省通化市东昌区、山西省晋中市榆次区、河南省周口市川汇区、湖南省长沙市岳麓区、江西省南昌市青山湖区、陕西省渭南市临渭区、广西壮族自治区桂林市七星区及青海省格尔木市990名3～4岁的城市儿童.采用《儿心量表-Ⅱ》对儿童的神经心理发育水平进行测查.儿童及其父母的人口学特征采用面对面问卷调查收集.结果 多元线性回归方程在调整了父母年龄、文化程度、家庭月均收入、孕期增重、生产方式及产次因素后,与母乳持续时间＜6月的儿童相比,母乳持续时间＞12月儿童的大运动发育水平β(95％CI)值为2.51(1.11～3.57),语言发育水平β(95％CI)值为3.62(1.21～4.84),差异均有统计学意义(均P＜0.05).与母乳持续时间＜6月的儿童相比,母乳持续时间6～12月儿童的语言发育水平β(95％CI)值为2.47(1.10～3.28),差异有统计学意义(P＜0.05).结论 母乳持续时间与学龄前儿童大运动、语言发育水平呈正相关关系.因此,鼓励母乳喂养并延长母乳喂养时间有益于儿童神经心理发育.

目的 研究分析0～24月龄婴幼儿贫血对不同能区神经心理发育状况的影响.方法 数据来源于"中国儿童心理发育数据分析及报告和图集制作"课题,共4 903名0～24月龄婴幼儿及其家长纳入本研究.儿童及其家长的人口学特征由经过统一培训的调查员进行面对面调查.采用血红蛋白检测方法(Hemocue法)测定全血血红蛋白,儿童的神经心理发育水平由经过培训的儿童保健人员采用"儿心量表-Ⅱ"进行测查.结果 0～24月龄婴幼儿血红蛋白水平是(116.96±13.15)g/L,贫血率为15.56％.在调整性别、月龄、民族、区域、喂养方式、母孕期情况和父母亲年龄、职业和文化程度等因素之后,贫血婴幼儿在精细动作(β值=-2.23,95％CI:-3.54～0.92)、语言(β值=-2.34,95％CI:-3.61～1.06)和全量表(β 值=-1.31,95％CI:-2.17～0.46)的发育商得分显著低于非贫血儿童.在大运动、适应能力和社会行为3个能区,贫血婴幼儿低于非贫血儿童,但差异无统计学意义(P＞0.05).结论 0～24月龄婴幼儿贫血对于婴幼儿总发育商有一定的影响,并且主要表现在精细动作和语言两个能区上.