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  • Title: [Survey on gross motor development of infants in nine cities of China in 2015].
    Author: Zhang YQ, Li H, Wu HH, Zong XN.
    Journal: Zhonghua Er Ke Za Zhi; 2018 Dec 02; 56(12):923-928. PubMed ID: 30518006.
    Abstract:
    Objective: To analyze the current situation of gross motor development of infants in nine cities of China and their relationship with physical growth. Methods: Healthy full-term infants aged 1-24 months were investigated by cross-sectional survey, which was carried out in nine cities (Beijing, Harbin, Xi'an in northern, Shanghai, Nanjing, Wuhan in central, and Guangzhou, Fuzhou, Kunming in southern regions of China) from June to October in 2015. Subjects were grouped into 12 age groups (1-<2, 2-<3, 3-<4, 4-<5, 5-<6, 6-<8, 8-<10, 10-<12, 12-<15, 15-<18, 18-<21, 21-<24 months). Gross motor development of infants was examined by fieldworkers and the information on parental education, family income and birth status were obtained by questionnaire. Weight, length and head circumference was measured by fieldworkers according to standard methods in the fields and their Z scores were calculated by using WHO growth standard. Z scores of weight (WZ), length (LZ) and head circumference (HCZ) <-2 s was considered as lower group, -2 s-<-1 s as medium-lower group, -1 s-1 s as medium group, 1 s-<2 s as medium-higher group and ≥2 s as higher group. The age of gross motor development was calculated by Probit regression analysis and χ(2) test was used for comparison of categorical data. Results: (1) The number of infants whose gross motor development was examined were 88 968 in the nine cities. The proportion of achievement of motor development became larger with the chronological age, i.e. it was 11.1% (800/7 236) at 5-<6 months, 65.2% (4 921/7 545) at 6-<8 months and 98.5% (7 417/7 531) at 8-<10 months for sitting alone without support. There was no gender difference in the proportion of achievement of sitting alone without support, hand-knee crawl, stand alone and walk alone (χ(2)=2.873, 0.275, 0.250, 0.576, all P>0.05). (2) The median age of achievement of sitting alone without support, hand-knee crawl, stand alone, walk alone was respectively 5.9, 7.8, 10.8, 13.0 months, and their ranges from 1(st) to 99(th) percentile were respectively 4.2-8.3 months, 4.9-12.6 months, 7.6-15.4 months, 9.8-17.4 months. The gender difference of median age of gross motor development was 0.0-0.1 months and their regional difference was 0.0-0.7 months. (3) In the lower weight group, their median age of sitting alone without support and walk alone were 0.2-0.6 months later than the medium weight group, while their median age of hand-knee crawl and stand alone were similar to those of the medium weight group. In higher weight group, the median age of sitting alone without support and stand alone were similar to that of the medium weight group, while their median age of hand-knee crawl was 0.3 later months and their median age of walk alone was 0.3 months earlier than that of the medium weight group. There was no significant relationship between length and the age of sitting alone or standing alone (the difference was 0.0-0.2 months in each group). The median age of hand-knee crawl and walk alone was 0.4-0.7 months later in lower length group than in other length groups. The median age of gross motor development was similar among different head circumference groups (0.0-0.2 months). The relationship between weight/length and motor development was similar to that between weight and motor development. Conclusions: There were no gender difference and slightly regional difference in the age of achievement of gross motor skills. The percentile age of gross motor skills helps to understand the population variation in healthy infants. The gross motor development is related with weight, length and body proportion. 目的： 掌握9个城市婴幼儿大动作发育的现状并分析其与体格发育的关系。 方法： 2015年6—10月在我国北部地区的北京市、哈尔滨市、西安市，中部地区的上海市、南京市、武汉市和南部地区的广州市、福州市、昆明市9个城市，采用分层整群抽样的方法对1~24月龄婴幼儿进行横断面调查，6月龄以内每个月龄1组，6~12月龄每2个月龄1组，12~24月龄每3个月龄1组。现场测查获得独坐、手膝爬、独站、独走4项大动作发育现状，测量婴幼儿体重、身长和头围，并按世界卫生组织（WHO）标准计算Z分值，体重、身长、头围Z分值<-2标准差（s）为低，-2 s~<-1 s为中下，-1 s~1 s为中，1 s~<2 s为中上，≥2 s为高。问卷获得婴幼儿的家庭状况、出生及喂养等信息资料。应用Probit概率单位回归法计算大动作发育月龄，计数资料组间比较用χ(2)检验。 结果： （1）9个城市共88 968名婴幼儿进行大动作发育调查，随年龄增长大动作技能的通过率逐渐增加，如独坐从5~<6月龄组的11.1%（800/7 236）、6~<8月龄组65.2%（4 921/7 545）至8~<10月龄组98.5%（7 417/7 531）。男、女童大动作（独坐、手膝爬、独站和独走）通过率差异均无统计学意义（χ(2)=2.873、0.275、0.250、0.576，P均>0.05）。（2）独坐、手膝爬、独站、独走的中位月龄依次为5.9、7.8、10.8、13.0月龄，第1~99百分位月龄依次为4.2~8.3、4.9~12.6、7.6~15.4、9.8~17.4月龄。大动作发育中位月龄男女相差0.0~0.1个月、地区相差0.0~0.7个月。（3）低体重组独坐、独走月龄比中体重组晚0.2~0.6个月，手膝爬、独站月龄与中体重组无明显差别（相差0.0~0.1个月）；高体重组独坐、独站与中体重组无差异，手膝爬晚0.3个月，独走早0.3个月；身长与独坐、独站月龄关系不明显（各组相差0.0~0.2个月），但低身长组手膝爬、独走年龄月龄略晚于其他身长组（0.4~0.7个月）；不同头围水平的独坐、独站、独走月龄差异不大（0.0~0.2个月）；体重/身长与大动作发育的关系与体重一致。 结论： 大动作发育无性别差异、存在小幅地区差异；百分位月龄有助于了解婴幼儿大动作发育的人群变化范围。身长、体重、体型与婴幼儿大动作发育有关。.
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