| Objective1.To investigate the temperament and sleep characteristics of preterm infants.2.To investigate the relationship between temperament characteristics and hours of sleep in preterm infants.Subjects and Methods1.Subjects1.1 Preterm group:To select study subjects in neurological rehabilitation clinic of Guangzhou Women and Children's Medical Center by randomly.The preterm infants were born from April 1, 2009 ~ March 30, 2010, excluding congenital malformations, common genetic metabolic disorders and a variety of brain damage.Their gestational age was from 28w to 36+6w, birth weight was 1.5 ~ 2.5kg (including 1.5kg, excluding 2.5kg). A total of 100 cases(62 boys and 38 girls), boys to girls ratio was 1.63:1.The age was between 4 months and 12 months, mean age was 7.72±2.48 months.1.2 Full-term group:To select study subjects in child health clinic of Guangzhou Women and Children's Medical Center by randomly. The preterm infants were born from April 1, 2009 ~ March 30, 2010,excluding congenital malformations, common genetic metabolic disorders and a variety of brain damage.Their gestational age was from 37w to 42w, birth weight was 2.5 ~ 4.0kg (including 2.5kg, excluding 4.0kg). A total of 96 cases(63boys and 33 girls) boys to girls ratio was 1.91:1.The age was between 4 months and 12 months,mean age was 7.34±2.20 months.2.Methods 2.1 Data collection: Information was collected from all subjects by using Carey 4 months to 1 year old infant temperament rating scale and infant sleep questionnaire(maded by ourselves).2.2 Data arrangement: To assess all subjects's temperament,and obtained the nine temperament factor scores.According to the first five temperament factors,to divided all subjects's temperament into four temperament types:easy to raise type, intermediate type, slow startup type and difficult to raise type. To fill the information of the infant sleep questionnaire into EXCELL form and calculate the hours of sleep at night, hours of sleep in daytime and total hours of sleep.2.3 Statistical analysis: The comparison of parents's occupation,education and all subjects's perinatal conditions,feeding conditions,sleep environment,sleep habits, sleep conditions and temperament type between preterm group and full-term group were performed using Chi-square test for R×C table. The comparison of temperament factors and hours of sleep between preterm group and full-term group were used t-test/rank test.The analysis on relationship between temperament factors and hours of sleep were sued bivariate correlation analysis. The comparison of hours of sleep between preterm infants withing different temperament were used One-Way ANOVA analysis. All data were analyzed with statistical software SPSS16.0. Statistical analysis of test levelα= 0.05.Results1.The comparison of the general informationThere were no significant difference between preterm group and full-term group in the parental age, parental educational and parental occupation(P>0.05).2. The comparison of the perinatal conditions between preterm group and full-term groupThe mean gestational age of preterm infants was 34.09±2.79 months and their average birth weight was 2.14±0.56kg.The average gestational age of full-term infants was 38.33±4.77 months and their mean birth weight was 3.26±0.48kg. The difference between the two groups in gestational age and birth weight was statistically significant (P <0.05).There were no significant difference in jaundice fade time between preterm group and full-term group(P> 0.05).Both of the preterm group and full-term group had no birth asphyxia,save history,history of bilirubin encephalopathy and all had newborn screening and screening results were normal.3. The comparison of the feeding methods between preterm group and full-term groupThere were no significant difference between the two groups in weaning time,complementary feeding time and the time to start using the bottle,dairy products and now diets features(P> 0.05).The two groups had statistically significant difference in feeding (P <0.05).In the preterm group,the highest proportion was artificial feeding(49%), while 23% of breast-feeding, mixed feeding was 28%.In the full-term group,mixed feeding group accounting for 50%,the proportion of breastfeeding and artificial feeding was 27.1% and 22.9%.4. The comparison of the sleep habits between preterm group and full-term groupThere were no significant difference between preterm group and full-term group in the sleep environment,sleep preferences,sleep posture and the situation to turn around when sleeping(P> 0.05).5. The comparison of the hours of sleep between preterm group and full-term groupIn the preterm group,there were 16 infants required more than 1 hour,24 infants required 0.5 ~ 1 hour, 35 infants required 0.5 hours, 25 infants required 5 to 10 minutes to fall asleep, respectively account for 16%,24%,35% and 25%.In the full-term group,the percentages respectively accounted for 5.2%,13.5%,37.5% and 43.8%.The preterm group needed longer time to fall asleep compared with full-term group(P <0.05).There were no significan difference between the two groups in hours of sleep in daytime(P>0.05).The preterm group required longer average time(22.15±17.54min) to fall asleep again after wakeing up at night than the full-term group(13.44±11.90min)(P <0.05). The average hours of sleep at night of the preterm group(9.53±1.20h) were less than that of the full-term group(9.96±1.18h) (P <0.05).6.The comparison of the sleep conditions between preterm group and full-term groupThere were differences between preterm group and full-term group in the following sleep conditions: not want to sleep at sleep time, difficult to fall asleep in bed,woke up more than 2 times per night,difficult to fall asleep again after waking up at night,wakeing up screaming or confusion,sleepy during the day, suddenly fall asleep in inappropriate occasions.The proportion of abnormal sleep conditions which mentioned above in preterm group(respectively 21.00%, 26.00%, 31.00%, 10.00%, 7.00%, 14.00%, 5.00%) were higher than that in full-term group (2.08%, 9.375%, 15.625%, 2.08% 0.00%, 4.17%, 0.00%),and the proportion of normal sleep conditions in preterm group(respectively 79.00%, 74.00%, 69.00%, 90.00%, 93.00%, 86.00%, 95.00%) were shorter than that in full-term grorp ( 97.92%, 90.625%, 84.375%, 97.92%, 100%, 95.83%, 100%), (respectively P<0.01, 0.01, 0.05, 0.05,0.01, 0.05,0.05).7. The comparison of constiuent ratio of temperament types and the scores of temperament factor between preterm group and full-term groupThe proportion of difficult to raise type,intermediate type,slow startup type in preterm grop(21%, 45%, 10%) was higher than that in term group(7.25%, 31.3%, 6.25%)(P <0.01).The proportion of easy to raise type in full-term group(55.2%) was higher than that in preterm group(24%)(P <0.01).The scores of rhythmicity, avoidance, adaptability, emotional nature, persistence in preterm group (respectively, 3.24±0.64,3.20±0.78,3.03±0.56,3.68±0.67,3.58±0.68) were higher than those in full-term group (Respectively 2.92±0.64,2.93±0.62,2.78±0.62,3.28±0.49,3.16±0.86)(P <0.01).The scores of activity level, intensity of reaction, distractibility, response threshold score in the two groups were no significant differences (P> 0.05).8.The comparison of sleep time between preterm infants withing diffrent temperament typeThe difficult to raise type and slow startup type preterm infants needed longer time to fall asleep again after waking up at night(respectively 28.81±24.34min,39.00±17.12min)than the easy to raise type and intermediate type(respectively 15.25±16.28,18.98±10.13min)(P <0.01).The hours of sleep in daytime in intermediate type and difficult to raise type (respectively, 3.40±1.05,3.53±1.31h) were less than that in the slow startup type(4.47±1.69h)(P <0.05).The total hours of sleep of the difficult to raise type(13.17±1.52h) was less than that of the easy to raise type (13.90±1.57)(P <0.05).9.The relationship between temperament and hours of sleep in preterm group Correlation coefficient(R) was 0.181(P<0.05)between avoidance and the time required for falling asleep again after wakeing up at night, 0.221(P<0.01)between adaptability and the time, 0.207(P<0.01)between emotional nature and the time. Correlation coefficient(R) was -0.223(P<0.01)between levels of activity and the totle hours of sleep,-0.217(P<0.01)between avoidance and the totle hours of sleep.Conclusions1.Difficult to raise type temperament in preterm infants was more than that in full-term infants,and the full-term infants's temperament were mainly easier to raise type.2.The sleep condition in preterm infants was poorer than that in full-term infants,such as:difficulty falling asleep, night waking.The hours of sleep at night of the preterm infants was less than that of the full-term infants. 3. Preterm infants withing different temperament types had different hours of sleep.The temperament dimensions were associated with hours of sleep in preterm infants. |
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