رابطه شاخص‌هاي رشدي هنگام تولد با وضعيت تكاملي در شيرخواران 6 تا 18 ماهه

The relationship between growth indices at birth and developmental status in infants aged 6 to 18 months

زمينه و هدف: بروز اختلالات تكاملي و رفتاري از شايع‌ترين مشكل در طب كودكان است. رشد و تكامل تحت تاثير عوامل ژنتيكي، محيطي و اجتماعي قرار دارد و مهمترين و آغازي‌ترين مرحله آن از دوران جنيني و نوزادي شكل مي‌گيرد. با توجه به اهميت تكامل، اين مطالعه با هدف بررسي ارتباط شاخص‌هاي رشدي هنگام تولد با وضعيت تكاملي انجام گرفت. روش بررسي: اين مطالعه مورد-شاهدي به بررسي شيرخواران 6 تا 18 ماهه پرداخت كه از مرداد تا آذر 1396 به مراكز جامع سلامت وابسته به دانشگاه علوم پزشكي قزوين مراجعه نمودند. حجم نمونه در اين بررسي 200 نفر بود و شركت‌كنندگان در دو گروه 100 نفره شيرخواران داراي تاخير تكاملي و شيرخواران با تكامل طبيعي مورد ارزيابي قرار گرفتند. شاخص‌هاي تن‌سنجي هنگام تولد از پرونده بهداشتي و وضعيت تكاملي با پرسشنامه سنين و مراحل سنجيده شد. يافته‌ها: ميانگين سني شيرخواران در گروه مورد 1/72±12/63 ماه و در گروه شاهد 1/69±12/68 ماه بود و 45/6% از كودكان داراي تاخير تكاملي دختر بودند. بيشترين شيوع تاخير تكاملي، در حيطه شخصي-اجتماعي (26/9%) و كمترين شيوع در حيطه حركات درشت (12/7%) بود. ارتباط معناداري بين دور سر (0/32=P) و قد هنگام تولد (0/11=P) و وضعيت تكاملي وجود نداشت. درحالي‌كه ارتباط معناداري بين تاخير تكاملي در حيطه برقراري ارتباط (0/04=P) و در حيطه حركات درشت (0/02=P) با وزن هنگام تولد وجود داشت. نتيجه‌گيري: به‌نظر مي‌رسد، وزن هنگام تولد با تاخير تكاملي رابطه داشته باشد. در اين مطالعه وزن كم هنگام تولد با تأخير تكاملي در حيطه‌هاي برقراري ارتباط و حركات درشت رابطه داشت.

Background: Developmental and behavioral disorders are the most prevalent problems in children after infection and trauma. Growth and development are influenced by genetic, social and environmental factors that incept of the early life of the fetal and neonatal periods. Due to the importance of the development in children, this study was conducted to determine the relationship between growth indices at birth and developmental status in infancy. Methods: This case-control study investigated 6 to 18 months old infants, who referred to comprehensive health centers affiliated to Qazvin University of Medical Sciences, Iran, from August to December 2017. The sample size in this study was 200 infants and the participants were evaluated in two groups of 100 subjects (developmental delay and normal development). Anthropometric indices at birth were collected from healthcare records, and developmental status was measured using the ages and stages questionnaire (ASQ). The developmental status of the children was measured in five domains, i.e., motor (gross and fine motor skills), problem-solving, personal-social skills and communication. A significance level was considered statistically <0.05. Results: The mean age of the infants in the developmental delay group was 12.63±1.72 months and the mean age of the infants in control group was 12.68±1.69 months and 45.6% of children in the developmental delay group were female and 54.4% of children in the developmental delay group were male. The most prevalence developmental delay in case group was in the area of personal-social domain (26.9%) and the lowest prevalence developmental delay in the area of the gross motor (12.7%). No correlation was found between head circumference (P= 0.32) and height at birth (P= 0.11) and developmental status. However, there was a significant relationship between developmental delay in the area of the communication (P= 0.04) and gross motor (P= 0.02) with birth weight. Pearson correlation indicate a correlation between developmental delay in the area of the gross motor and birth weight (P= 0.01). Conclusion: It seems that birth weight was a factor that is associated with developmental delay. In this study low birth weight correlated with developmental delay in communication and gross motor aspects of ASQ.