食物过敏儿童社会情绪发展的影响因素分析

李国凯; 高学杰; 叶红; 刘桂华

doi:10.19757/j.cnki.issn1674-7763.2023.03.004

食物过敏儿童社会情绪发展的影响因素分析

Analysis on factors associated with socio-emotional development among children with food allergy

摘要

摘要:
目的了解和分析12 ~ 24月龄食物过敏儿童社会情绪发展异常的影响因素, 为食物过敏儿童心理健康防治提供依据。
方法选取2021年1月— 2022年1月在某三级甲等妇幼保健院过敏专科门诊就诊的12 ~ 24月龄食物过敏儿童122例为研究对象, 采用12 ~ 36月龄幼儿情绪社会性发展评估量表(Chinese Infant and Toddler Social-Emotional Assessment, CITSEA)和病史问卷等调查工具, 根据CITSEA中19个因子结果, 将发生一项或多项社会情绪因子异常儿童作为研究组, 未发生社会情绪因子改变的正常儿童作为对照组, 分析影响儿童社会情绪发展的可能因素。
结果有一项或多项社会情绪因子异常的研究组儿童共80例(65.57%), 未发生社会情绪因子改变的对照组儿童共42例(34.43%)。食物过敏儿童CITSEA中异常因子检出率最高前3位依次为饮食因子(36.89%、45/122)、睡眠因子(36.07%、44/122)和负性情绪因子(34.43%、42/122)。影响儿童社会情绪发展的单因素分析结果显示, 两组儿童在母乳喂养时间、辅食添加态度、牛奶相关症状评分(Cow’s Milk Related Symptom Score, CoMiSS)、母亲目前焦虑状态、食物过敏种类数方面的比较差异均有统计学意义(均P < 0.05)。多因素logistic回归分析结果显示, 母亲焦虑状态、食物过敏种类数多是儿童社会情绪发展的危险因素(OR = 12.933, 95% CI：3.032 ~ 55.165；OR = 15.282, 95% CI：3.692 ~ 63.261), 母乳喂养时间 > 6个月是社会情绪发展的保护因素(OR = 0.133, 95% CI：0.028 ~ 0.626)。
结论食物过敏儿童社会情绪发展异常主要表现在饮食问题、睡眠问题和负性情绪方面；母亲焦虑状态、食物过敏种类数量多可能不利于儿童的社会情绪发展；母乳喂养时间 > 6个月可能有利于儿童的社会情绪发展。

Abstract:
Objective To identify and analysis the factors associated with abnormal socio-emotional development among children aged 12 - 24 months with food allergy, so as to provide evidence for mental health prevention and treatment for them.
Methods 122 children aged 12 - 24 months with food allergy who visited allergy clinic at a tertiary Maternity and Child Health Hospital from Jan 2021 to Jan 2022 were recruited as study subjects. Based on the scores of 19 factors from Chinese Infant and Toddler Social Emotional Assessment (CITSEA) for children aged 12 - 36 months, CITSEA and questionnaire about medical history were used to identify children with one or more social emotional abnormalities as study group, while children without social emotional abnormalities were assigned to the control group. Factors associated with children's social emotional development were analyzed.
Results There were 80 children (65.57%) in the study group with one or more abnormal social emotional factors, and 42 children (34.43%) in the control group without normal social emotional factors. The top 3 abnormal factors were diet (36.89%, 45/122), sleep (36.07%, 44/122) and negative emotion (34.43%, 42/122) among children with food allergy. Univariate analysis showed that breastfeeding duration, attitude toward supplementing with complementary food, Cow's Milk Related Symptom Score (CoMiSS), mother's current anxiety status, and number of types of food allergies were different between study and control group (P < 0.05). Logistic regression analysis indicated that mother's anxiety status and number of types of allergenic foods were risk factors (OR = 12.933, 95% CI: 3.032 - 55.165; OR = 15.282, 95% CI: 3.692 - 63.261, respectively), while breastfeeding > 6 months was a protective factor (OR = 0.133, 95% CI: 0.028 - 0.626) for children's socio-emotional development.
Conclusion Abnormal socio-emotional development among children with food allergy is mainly manifested in eating problems, sleep problems and negative emotions. Mother's anxiety status, number of types of allergenic foods and breastfeeding duration could affect children's socio-emotional development.

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