| ObjectivesThe physical development and prevalence rate of neurobehavioral developmental disorders of newborns was variated at different gestational ages.The purpose of this study was to screen the motor coordination ability and the prevalence rate of Developmental Coordination Disorder(DCD)among preschool children at different gestational ages.In order to conduct monitoring and intervening of early child development,we will explore the differences of motor coordination ability in early child development,and find the factors which affected motor coordination ability of children.Methods(1)During May and June of 2018,9833 preschool children aged 3-6 years were selected from 174 kindergartens in 4 districts of shanghai(Jing'an,Pudong,Songjiang and Minhang).Their motor coordination ability was assessed by using Little Developmental Coordination Disorder Questionnaire.Measurement data between two groups were analyzed by t-test,three or more groups were analyzed by One-way ANOVA.Enumeration data were analyzed by Chi-square.The trend test was used to assess the change trends of scores with age.(2)During January to April of 2017,2646 infants aged 0 to 18 months were selected and tested in a maternal and children's hospital in a district of Shanghai.The motor ability and cognitive development of children was assessed by Bayley-III Screening Test.Measurement data between two groups were analyzed by t-test,three or more groups were analyzed by One-way ANOVA.(3)The population and research tools in this part were the same as that in the second part.The t-test and logistic regression analysis were used to analyzed the related factors which affected the motor ability and cognitive ability of 2646 infants.Results(1)The scores of motor coordination ability in preterm infants,early term infants and full term infants were 66.78±9.36,67.71 ±8.59 and 68.29±8.18 respectively,and there was significant difference between each other(F=16.13,p<0.001).Preterm infants and early term infants lagged behind full term infants in motor coordination ability(Q were 7.54 and 4.26,each p<0.05).The prevalence rate of DCD in three groups was 6.6%,4.9%and 3.7%respectively,which showed significant difference between each other(?2=20.10,p<0.001).The prevalence rate of DCD in preterm infants and early term infants was higher than that in full term infants(?2 were 18.388 and 6.462,each p<0.0125).Girls acquired higher scores of motor coordination ability than boys(t=8.62,p<0.01).Boys had a higher prevalence rate of DCD than that of girls(?2=20.87,p<0.001).The scores of motor coordination ability in 3-year-old age group,4-year-old age group,5-year-old age group and 6-year-old age group were 65.60±9.11,67.29±8.57,68.88±8.00 and 70.07±7.45,there were statistical differences between four groups(F=100.60,p<0.001)There were statistical differences between control during movement,fine motor and general coordination(F were 62.53,145.61 and 68.18,each p<0.001).The scores of each subtest gradually increased with age(Mann-Kendall test,each p<0.001).The prevalence rate of DCD in 3-year-old age group,4-year-old age group,5-year-old age group and 6-year-old age group was 7.0%,4.7%,3.5%and 2.7%,there were significant differences in the prevalence of DCD among different age groups(?2=46.63,p<0.001).The prevalence rate of DCD decreased with age(?2=43.43,p<0.001).(2)Comparisons among preterm infants,early term infants and full term infants,there were significant differences in gross motor,fine motor and cognitive development(F were 11.90,9.65 and 9.65,each p<0.001).The scores of three subtests in early term infants were lower than full term infants(Q were 6.05,5.71 and 4.26,each p<0.05).Comparisons were made among three groups in gross motor,fine motor and cognitive subjects at different months.At the age of 12-18 months,the scores of preterm infants were lagged behind full term infants in fine motor(Q=3.43,p<0.05),the scores of early term infants were lagged behind full term infants in gross motor and fine motor(Q were 4.17 and 3.32,each p<0.05).(3)Children whose mothers were older than 35 years old had lower scores in gross motor,fine motor and cognitive subjects than those whose mothers were younger than 35 years old(t were 2.94,2.80 and 2.68,each p<0.01).There were no significant differences in the scores of gross motor,fine motor and cognitive subjects between low birth weight infants and normal birth weight infants(p>0.05).There were no significant differences between different genders either(p>0.05).After adjusted for maternal age,gender,birth weight and gestational ages,the results of logistic regression analysis showed that,compared with children whose mothers were older than 35 years of age,those children whose mothers were younger than 35 years old had protective effects in gross motor(OR=0.706,95%CI=0.523-0.953).At the same time,those children whose mothers were younger than 35 years old had protective effects in fine motor(OR=0.716,95%CI=0.543-0.943).Compared with full term infants,the risk of gross motor in preterm infants had increased 96%(OR=1.960,95%CI=1.264-3.037).The risk of fine motor in early term infants had increased 19.2%(OR=1.192,95%CI=1.006-1.412).Conclusions(1)The motor coordination ability of preterm infants and early term infants at preschool age were lower than that of full term infants,and the prevalence rate of DCD was higher than that of full term infants.The motor coordination ability of boys was lower than girls,the prevalence rate of boys was higher than that of girls.The motor coordination ability of preschool children was gradually increased with age,and the prevalence rate of DCD was decreased with age.(2)The scores of gross motor,fine motor and cognitive subjects of early term infants and preterm infants were lower than those of full term infants.The age of 12-18 months was a critical period for the development of gross motor and fine motor in premature and early term infants.(3)Mothers were older than 35 years old increased children's risk of lagging behind in gross motor and fine motor.Compared with full term infants,preterm infants had an increased risk of gross motor,and early term infants had an increased risk of fine motor. |
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