1.Report on early childhood development practices in China from a global health perspective
Chinese Journal of Child Health Care 2024;32(1):1-6
As the health disparities among children indirectly reflect the unfair distribution of national child healthcare, education, and other infrastructure, early childhood health development is a globally significant public health concern. On a global scale, 193 countries have endorsed The 2030 Agenda for Sustainable Development and have explored various development strategies. The government placing children′s interests and their rights at the core of their efforts to achieve the Sustainable Development Goals(SDGs) is essential, China has made substantial progress in improving children′s well-being over several decades of continuous effort and practice. However, challenges persist, including regional development imbalances, insufficient service capabilities in impoverished rural areas, and emerging issues like obesity, myopia, and mental health problems. China still needs to meet the growing health needs of children fully. From a global health perspective, this article systematically reviews the current status of global early childhood health development, outlines the significant milestones and best practices in China′s early childhood development efforts, and also anticipates the focus and challenges in early childhood development in China based on global trends, hoping to contribute to further research in this field.
2.Association of sexual development characteristics and phases with the cognitive and behavioral development of adolescents aged 10 to 14 in rural areas of Shaanxi Province
Liang WANG ; Yingze ZHU ; Qi QI ; Zhonghai ZHU ; Lingxia ZENG
Chinese Journal of Child Health Care 2024;32(1):10-15
【Objective】 To analyze the association of sexual development characteristics and phases with the cognitive and behavioral development of adolescents aged 10 to 14 in rural areas of Shaanxi Province, in order to provide scientific reference for enhancing adolescent health. 【Methods】 The study population was selected from a birth cohort study′s follow-up data for the adolescent phase. The Tanner quintile method was used to assess sexual development, the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ) was used to assess cognitive development, and the Youth Self-Rating Scale(YSR-2001) was used to assess behavioral development. Generalized linear models was used to examine the association of the stages of adolescent sexual development with their cognitive and behavioral development. 【Results】 A total of 1 887 adolescents were enrolled in this study, with 1 111 (58.9%) boys. The proportion of boys and girls who have started sexual development was 78.22% and 89.30%, respectively. The detection rate of behavioral problems in adolescents was 9.70%, with 11.80% in boys and 6.70% in girls, and the gender difference was significant (χ2=13.517, P<0.001). Compared to adolescents in Tanner stage Ⅰ, adolescents in stage Ⅲ had a higher total cognitive score of 2.19 (95%CI: 0.15 - 4.23), and a higher total score of 3.84 (95%CI: 0.85 - 6.83,P<0.05) in stages Ⅳ-Ⅴ. The detection rate of total behavioral problems of children in Tanner stages Ⅳ-Ⅴ was 2.63 times (95%CI:1.27 - 5.46,P<0.05) higher than that in stage Ⅰ. In boys, the rate of detection of internalizing problems was 3.96 times(95%CI:1.60 - 9.81,P<0.01) higher than that in stage Ⅰ, and the detection rate of internalizing problems was 2.88 times(95%CI:1.19 - 7.01,P<0.05) higher than that in stage Ⅰ. 【Conclusions】 There is a significant correlation of sexual developmental phrase with cognitive and behavioral development among adolescents aged 10 - 14 years in rural Shaanxi Province. The detection rate of adolescent behavioral problems increases with the increase of sexual development level and cognitive level, and there are significant gender differences.
3.Effect of polygenic risk score in the sustainability of childhood obesity intervention
Jing CHEN ; Rui SHAN ; Wucai XIAO ; Jieyun SONG ; Zheng LIU
Chinese Journal of Child Health Care 2024;32(1):16-20
【Objective】 To explore the relationship between polygenic risk score (PRS) and the sustainability of childhood obesity intervention, in order to provide scientific basis for future sustainable and personalized childhood obesity intervention based on genetic background. 【Methods】 A total of 148 children with overweight/obesity at baseline were selected as study subjects from a cluster randomized controlled trial (September 2018 to April 2021) regarding the effect of a childhood obesity intervention in Beijing, China. Saliva was collected to detect the whole genome sequencing. Four PRSs were built: weighted and unweighted PRS
4.Status quo of preterm infants′ feeding difficulties at weaning and self-feeding transition stage and its influencing factors
Die CHEN ; Wentao PENG ; Mengyan TANG ; Xiaomei LIU
Chinese Journal of Child Health Care 2024;32(1):21-25
【Objective】 To investigate the prevalence and influencing factors of feeding difficulties in preterm infants at weaning and self-feeding transition stage, so as to provide a scientific basis for the management of feeding preterm infants. 【Methods】 Preterm infants at corrected age of 6 - 24 months were recruited from the Department of Child Health of five maternal and child health hospital of Chengdu from April to May 2021, and were surveyed by using the Chinese Version of the Montreal Children Hospital Feeding Scale (MCF-FS) and the self-designed questionnaire on the influencing factors of feeding difficulties. Then the status quo of feeding difficulties and its influencing factors were analyzed. 【Results】 The prevalence rate of feeding difficulties in 231 preterm infants was 32%. Among them, the prevalence rate of mild, moderate and severe feeding difficulties was 15.2%, 7.8% and 9.1%, respectively. Binary Logistic stepwise regression analysis indicated that food allergy (OR=4.253, 95%CI: 1.430 - 12.649), anxious mood of caregivers (OR=6.064, 95%CI: 2.998 - 12.268), tease or chase during eating(OR=2.873, 95%CI: 1.382 - 5.970), recreational activities at eating (OR=2.328, 95%CI: 1.115 - 4.860), and forced feeding (OR=2.772, 95%CI: 1.239 - 6.198) were positively associated with feeding difficulty of preterm infants(P<0.05). 【Conclusion】 Feeding difficulties in the weaning and self-feeding transition period of preterm infants are prevalent, so the guidance should focus on premature infants with food allergy, anxious caregivers and improper feeding behaviors, and appropriate interventions should be taken to promote scientific feeding.
5.Status quo of screen exposure and its determinants in 3- to 6-year-old children in Minhang district, Shanghai
Min CHEN ; Hongmei ZHANG ; Shurong KANG ; Yun LI
Chinese Journal of Child Health Care 2024;32(1):26-30
【Objective】 To investigate the screen exposure status in 3- to 6-year-old children in Minhang district and to analyze its determinants, so as to provide a basis for scientific intervention of screen exposure in children. 【Methods】 A total of 1 035 children aged 3 to 6 years were selected from 30 classes in 10 kindergartens in Minhang district by multi-stage cluster sampling in October 2022. An online questionnaire survey was conducted by their parents. Screen exposure was difined as spending more than one hour on video products per day. Multivariate Logistic regression model was adopted to analyze the determinants of children screen exposure. 【Results】 Among 1 035 children, 730 experienced screen exposure (70.53%). The average time of daily screen exposure was (1.67±0.98)h. The daily screen exposure time of children aged 3, 4, 5 and 6 years at weekends was (1.77±1.13), (1.76±1.04), (1.98±1.10)h and(2.08±1.22)h, respectively, and the difference was statistically significant (F=3.98, P<0.01). Multivariate Logistic analysis showed that age group of 5 years old (OR=1.79, 95%CI:1.19 - 2.68), the caregivers using video products for 1 - 2hours/day (OR=2.61, 95%CI:1.90 - 3.60) and >2hours/day (OR=2.10, 95%CI:1.35 - 3.27) when accompanying children, parents supporting children using video products(OR=1.59, 95%CI:1.17 - 2.15), children using video products before bedtime(OR=1.94, 95%CI:1.32 - 2.86), and unsupervised use of video products for children(OR=1.94, 95%CI:1.36 - 2.77) were independent risk factors for children′s screen exposure(P<0.05). Father′s education level of bachelor(OR=0.61,95%CI:0.43 - 0.89), master and above(OR=0.49, 95%CI:0.34 - 0.73) was a protective factor for children′s screen exposure(P<0.05). 【Conclusions】 Attention should be paid to the problem of screen exposure of 3 -to 6 - year-old children. Targeted efforts should be made to popularize the knowledge of the harm of early screen exposure to children among caregivers, caregivers are advocated for the rule formulation of screen behavior, scientifically regulate children′s screen exposure behaviors, and increase parent-child communication, so as to reduce the adverse effects of screen exposure on children′s health.
6.Cross-sectional study on the association between gut microbiota composition and blood pressure in children
Guoqing FANG ; Xin ZHANG ; Dayong ZHA ; Shanshan CHEN ; Zhen HONG ; Zheqing ZHANG
Chinese Journal of Child Health Care 2024;32(1):31-38
【Objective】 To analyze the association between the composition of gut microbiota and blood pressure in children aged 6 - 9 years, in order to provide new ideas for childhood hypertension prevention and treatment. 【Methods】 A total of 411 children aged 6 - 9 years were recruited in Guangzhou from December 2015 to March 2017. The gut microbiota was characterized by 16S ribosomal RNA amplicon sequencing. The multivariate methods with unbiased variable selection in R (MUVR) were performed to identify the significant OTUs. Spearman correlation as well as multiple linear regression were used to explore the relationship between gut microbiota and blood pressure in children. 【Results】 Significant difference in β diversity index was observed between children with normal blood pressure and those with abnormal blood pressure (R2
7.Correlation of serum 25-(OH)D3 , albumin, ferritin with STAMP score and their predictive value for clinical outcome of preschool children with malnutrition
Jie SONG ; Linjuan HUANG ; Bidan GUO
Chinese Journal of Child Health Care 2024;32(1):39-44
【Objective】 To investigate the correlation of serum 25-hydroxyvitamin D
8.Obesity status of Kazakh children and adolescents in Xinjiang agricultural and pastoral areas and its correlation with lifestyle
Jingzhi LIU ; Qinxiu LI ; Yanyan HU ; ·Mamat AINUER
Chinese Journal of Child Health Care 2024;32(1):45-48
【Objective】 To understand the obesity status of Kazakh children and adolescents in the agricultural and pastoral areas of Xinjiang and its association with lifestyle, so as to provide reference and help for maintaining good body shape and health intervention for Kazakh children and adolescents in agricultural and pastoral areas. 【Methods】 From April to June 2022, 6 242 Kazakh children and adolescents aged 10 - 20 years were tested for obesity and surveyed by lifestyle questionnaires using stratified whole-group sampling in the farming and herding areas of Yili Kazakh Autonomous Prefecture and Altay Region, Xinjiang. χ2 test and Logistic regression analysis were used to analyze data. 【Results】 The obesity detection rate of Kazakh children and adolescents in Xinjiang farming and herding areas was 18.71%, with higher rates in boys (22.24%) compared to girls (15.12%), and the difference was statistically significant (χ2 =52.04, P<0.01). Significant differences were observed in the obesity rates based on grade level, fruit consumption frequency, screen time of television, feeling hopeful for the future, fatigue, loneliness, and sadness (χ2 =24.29, 4.61, 694.51, 7.15, 10.33, 6.51, 8.07, P<0.01). Logistic regression analysis showed that female students (OR=0.63, 95%CI: 0.56 - 0.69) and students who felt hopeful about the future (OR=0.96, 95%CI: 0.94 - 0.99) were protective factors against obesity (P<0.05); while high school and lower grades (senior high school OR=1.38, 95%CI: 1.24 - 1.57; junior high school OR=1.82, 95%CI: 1.58 - 2.06; primary school OR=2.67, 95%CI: 2.33 - 2.99), fruit consumption ≥1time/d (OR=1.07, 95%CI: 1.03 - 1.16), watching TV ≥2h/d (OR=1.07, 95%CI: 1.02 - 1.17), frequent feeling of fatigue (OR=1.07, 95%CI: 1.03 - 1.12), loneliness (OR=1.08, 95%CI: 1.02~1.19) and sadness (OR= 1.09, 95%CI: 1.04 - 1.14) of students were risk factors for the development of obesity (P<0.05). 【Conclusions】 The obesity rate of Kazakh children and adolescents in the agricultural and pastoral areas of Xinjiang is high and closely associated with lifestyle. Therefore, it is crucial to improve unhealthy lifestyles in order to reduce obesity and promote the physical and mental well-being of this population.
9.Research advance in the changes of bone mineral density during puberty
Chinese Journal of Child Health Care 2024;32(1):49-53
Bone mineral density is an important indicator of bone nutrition. The bone mineral density of children gradually increases with age, and the accumulation of bone mineral density in adolescence increases significantly, which is the most sensitive period to affect the peak bone mass. Sex hormone promotes bone formation and bone mineral density acquisition, and the peak secretion of growth hormone and insulin-like growth factor-1 increases bone mineral density accumulation. Children with precocious puberty develop earlier, and the length of puberty is shortened, resulting in changes in bone mass accumulation. GnRHa(gonadotrophin releasing hormone analogue) treatment of precocious puberty also affects bone metabolism. The level of 25-(OH)D
10.Research progress in the correlation between maternal depression and childhood obesity
Hongju ZHOU ; Ji GUAN ; Jing LUO ; Xuemei JU ; Jiaxin YU
Chinese Journal of Child Health Care 2024;32(1):54-58
Maternal depression can cause physical and mental harm to herself. This condition can lead to poor physical development in early offspring (newborns). However, the effect of maternal depression on the long-term physical development of offspring remains controversial. Studies have shown that offspring exposed to maternal depression in developed countries are at an increased risk of obesity. In view of the high incidence of maternal depression and childhood obesity in China, this article reviews the correlation between maternal depression and offspring obesity, aiming to provide insights for relevant research in China and offer references for the prevention and intervention of maternal depression and childhood obesity.