| 1. Purpose: To research on the effect on the city infants intelligence development, adaptation to the society and growth using the projects of integrated early child development. By doing this, we want to find out the measures to improve the population quality, to evaluate the possibility of integrated early child development in Maternal and Child Health Care institutions and to provide the scientific basis for the new service of Maternal and Child Health Care.2. Objects: 300 infants who born at the Maternity and Child Hospital of Henan Province and having registered permanent residence of zhengzhou city from August 2005 to February 2006 were taken as .study objects.and those were randomly divided into experimental and control groups. Every group has 150 infants.. All the infants included were healthy, and children with history of premature delivery, perinatal stage asphyxiation and other serious diseases were excluded. Their parents agreed the research.3. Methods:A prospective study was designed. The experimental group was accepted integrated early child development service from the doctors and professional trained nurses. The control group was accepted the general systemic health care. The essential questionnaire and child nursing publicity were given to the parents. The indicators on height and weight were measured one time per month for those babies under six months and once every two months for those babies over six months. The intelligence tests were done at 3rd, 6th and 12th month respectively. The babies hemoglobin were measured at 6th, 8th and 12th month age and their sleep behaviour were the survey at 5th, 8th and 12th month age respectively. The differences of physical and psychological development of in the two groups were evaluated.3.1 The general conditions investigated: The general conditions for all babies were investigated including the situations of their delivery, the height and weight of their born, the structure and economic status of their family, the ages and culture level of their parents.3.2 Control group: The control group was accepted the general systemic health care. The babies were given the physical examination at regular intervals and their keepers were received the regular nursing guidance. The babies had not taken part in the club activities and had not received integrated early child development service.3.3 Experimental group: The babies had taken part in the club activities and had received integrated early child development service. The project was established by the Ministry of Health of the People's Republic of China and was put into practice for the first time in Henan province with reference to the related books. The contents included:3.3.1 The gestation period health care: The babies' mother received the publicity of integrated early child development service from the beginning of their pregnancy. They studied the health care and neonate nursing knowledge during the gestation period.3.3.2 Special health care and nurturing guidance: The experimental group was received the specific health care guidance. We designed the detailed scheme and performed in the different month-ages babies.3.3.3 Neonatal training: After the babies were born 24 hours, we told the parents how to exercise the children's vision, hearing, touching and how to do the passive exercise.3.3.4 The parent-children activities: The babies were received the activities at regular times. The activity was done once every two weeks for those babies under six months age. The contents included touching the babies and all kinds of games. The other activity was done one time per week for those babies over six months age. The contents pay much attention to improving the children's ability such as the exercise of the children's motion, cognition capacity, emotion, language, attention, observation, ability to take care of themselves and social adaptive capacity. With appropriate toys and realia, the infants were trained in playing and games.3.4 The quality control: The quality control was executed in the cycle of "evaluation-instruction-developing- evaluation". Inspection and monitoring of the physical examination were carried out monthly for those babies from 1 month to 6 month, and every two month for those babies from 7 month to 12 month age. Inspection and monitoring of the neuro-mental development were carried out at 3rd,6th and 12th month age.3.5 The indicators of physical growth: the height, weight and hemoglobins were measured by the routine methods. The micro-elements were done by the atomic absorbing spectrum.3.6 The DST was used to the intelligence screening tests for those children at 3rd and 6th months and the Gesell was done for those children at 12th month age.3.7 The survey for the babies sleeping: the survey was performed for the babies at 5th, 8th and 12th month age.4. Results:4.1 In our study, there was not any significant between the experimental group and the control group for those paramenters including the ratio between the boys and girls, birth height, weight, feeding style, economic condition of the family, parents age, parents education, nutrition during pregnancy and delivery status etc.4.2 There were no significant differences between two groups physical growth indexes such as height, weight. The height and weight were 66.14±2.13 cm and 66.06±1.90cm, 6.82±1.06kg and 6.75±0.79kg(p>0.05) at 6th months age for experimental and control group respectively. The height and weight were 71.72±2.46cm and 69.53±2.54cm, 8.74±1.07 kg and 8.63±1.05 kg(p>0.05) respectively at 8th months age. The height and weight were 76.58±2.74cm and 76.37±2.56cm, 10.38±1.24kg and 10.22±0.95kg (p>0.05) respectively at 12th months age.4.3 The results for the biochemical indicators: There was no significant difference between two-group hemoglobin at 6th, 8th and 12th months.age The hemoglobin was 106.22±8.47g/L and 105.87±8.32g/L(p>0.05) at 6th months age for experimental and control group respectively. The hemoglobin was 109.40±8.52 g/L and 108.37±8.65 g/L (p>0.05) at 8th months age respectively. The hemoglobin was 118.32±7.76 g/L and 117.82±9.04 g/L (p>0.05) at 12th months age respectively.4.4 The results for the microelement indicators: There was no significant difference between two-group microelement of Zn, Fe, Mg, Ca and Cu at 8th months.4.5 The two group of the intelligence quotient: the intelligence quotient of the experimental group is better than the control group from 3 month to 12 month. The months age of experimental group was earlier than that of control group for those indicators of all kinds of mental development. These indicators of mental development are the rolling ball of eyes following on the table,covering bottle cap,neck extension to 45 degree and crawling.4.5.1 The result of developmental quotient at 3rd month: the developmental quotient at 3rd month were 99.58±8.96 and 93.28±8.46 for experimental and control group respectively(p<0.01); the motor was 6.30±0.41 and 6.03±0.18 respectively (p<0.01); the adaptation to the society was 6.43±0.38 and 6.00±0.37 respectively (p<0.01); the intelligence index was 12.21±0.58 and 11.67±0.66 respectively(p<0.01).4.5.2 The result of developmental quotient at 6th month: the developmental quotient at 6th month were 99.17±12.36 and 93.23±11.64 for experimental and control group respectively(p<0.01); the motor was 9.29±1.57 and 9.08±1.16 respectively (p<0.05); the adaptation to the society was 9.48±1.64 and 9.05±1.33 respectively (p<0.05); the intelligence index was 12.10±0.48 and 11.67±0.64 respectively(p<0.01)o4.5.3 The result of the developmental age(DA) and the developmental quotient(DQ) at 12 month ageThere was a significant difference between two groups for the society adaptability, fine motor, language and personal-society aspects(p<0.01). There was also a significant difference between two groups for the gross motor (p<0.05)4.6 The months age of the neuro-mental development indicators: The month age of experimental group for the senseperceptions , the gross motor , fine motor and personal-society aspects was earlier than that of control group for those indicators (p<0.01).4.7 The result of the sleeping state: There was no significant difference between two groups for the sleeping state of infants at 5th and 8th months. The sleeping state was different significantly between two group infants at 12th month.5. Conclusions:5.1 Integrated early child development can promote mental development of infants. But compared with other four index such as the society adaptability, fine motor, language and personal-society aspects, the gross motor is not so obvious as the other four index.5.2 Integrated early child development can improve the social adaptive capacity of infants. It is beneficial for the development of children's emotional quotient.5.3 The higher education of the parents, and the earlier they know about the Integrated early child development, the cleverer of their babies.5.4 The effect is limited to the physical growth of infants in the city. A further study will be done for the effect on the physical growth for the long-term development of infants who lived in the city and the infants who lived in the rural area.5.5 Integrated early child development can improve the sleeping state of infants, but it is more closely associated with nutrition intake, it is helpful to the physical and mental development of infants.5.6 In order to enforce the health education to the parents, improve their knowledge about integrated early child development, adapt to the need of society and child health care development, integrated early child development should be given regularly and it is the duty for the doctors who worked in the Child Health Care to provide the service to the parents.
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