雙親因素與幼兒健康之相關性研究：台灣出生世代研究之先驅調查 （三十六個月大）結果

Parental Factors and Child Health: Results of the Pilot Study (36 Months Old) of TBCS

朱少良(Shao-Liang Chu)

指導教授 ： 李孟智

中山醫學大學/醫學院/醫學研究所/碩士(2008年)

摘要

過去文獻顯示，父母親的社經背景、照護模式、教養態度、生活型態乃至社會的福利政策及健康資源，都可能會影響所生育子女的身心健康狀況。
本論文的研究目的在於探討：父母親雙方人口學特性和健康行為與三十六個月大幼兒健康的關係，家庭環境與照護模式與三十六個月大幼兒健康的關係以及新生兒出生指標與三十六個月大幼兒健康的關係。
本論文所探討的台灣出生世代研究先驅研究第三波乃以先驅研究第一波訪視的1783名個案為對象，於2006年11月至2007年2月進行出生後三十六個月大的訪視調查。問卷內容包含父母親之人口及社經背景、照護模式與幼兒之發展、健康狀態、健康照護及罹病情形。
總計共完訪1630名個案，完訪率為91.4%。將經卡方檢定具顯著意義之預測變項納入，使用多變項邏輯式迴歸分析各結果變項與預測變項的關係，結果如下：三十六個月大幼兒身高落後(<10th percentile)之預測因子為幼兒性別、是否為低出生體重及低一分鐘Apgar score與否；三十六個月大幼兒體重落後(<10th percentile)之預測因子為幼兒性別及是否為低出生體重；外籍母親是三十六個月大幼兒不會畫直線或橫線、不會在聽故事時注意看圖畫故事書及不會玩家家酒等結果變項之預測因子；三十六個月大幼兒未完成疫苗接種之預測因子為家中有無再添小寶寶；三十六個月大幼兒一年內曾掛急診之預測因子為是否為高齡產婦、母親自覺健康、母親一個月內有無吸煙及家中有無六歲以下幼兒需照顧；三十六個月大幼兒一年內曾住院之預測因子為是否早產、幼兒居住地及是否為高齡產婦；三十六個月大幼兒一年內曾意外事故送醫之預測因子為幼兒性別、父親有無規律運動及父親有無喝酒。
本論文研究的結果顯示，三十六個月大幼兒之身高體重成長存在顯著的男女差異，且低出生體重兒到三十六個月大時較易在身高體重落後；三十六個月大幼兒有多個發展指標落後與外籍母親相關；在三十六個月大幼兒疫苗接種完成率方面，主要與家中有再添小寶寶有相
關；三十六個月大幼兒罹病及就醫之情形，則主要與母親因素有關，高齡產婦的幼兒住院及送急診的機會較低，而母親吸煙是幼兒掛急診的危險因子，此外，幼兒意外事故送醫則存在著明顯的男女差異，且父親有喝酒是危險因子。我們的結論是，出生指標與父母親的健康行為與照顧方式會影響幼兒三十六個月大的生長發展與健康。

關鍵字

出生世代研究 ； 雙親因素 ； 幼兒健康

並列摘要

The aim of this pilot study of wave III of TBCS (Taiwan Birth Cohort Study) was to examine the relationship between parental variables and the health of 36-month-old children.
The subjects of our study were the 1783 babies and their caregivers who were randomly selected and had previously completed the questionnaire for the pilot study of 6-month-old babies of TBCS. Data collection was carried out through household interviews using pre-tested questionnaires during November 2006 and February 2007. The final sample size was 1630 children whose mother or main caregivers had completed the questionnaire. The response rate was 91.4%.
Univariate analysis was used to examine the relationship between predictive variables and outcome variables of children health. Those statistically significant variables were further selected to establish multiple logistic regression models. The odds ratios between parental variables and children health were estimated. The results were as following: The predictive factors for the children whose body height less than 10th percentile were gender, low birth weight, and low 1-minute Apgar score. The predictive factors for the children whose body weight less than 10th percentile were gender and low birth weight. The predictive factor of developmental delay of the children was mother of foreign nationality. The predictive factor of complete vaccination was the child having a younger brother or sister. The predictive factors of hospitalization within 1 year were prematurity, rural/urban residence, and older mother. The predictive factors of bringing children to emergency room within 1 year were older mother, maternal self-aware health, maternal smoking, and if any other children under 6 year old in the family. The predictive factors of bringing children to hospital due to occurrence of accidents were gender, paternal regular exercise, and paternal drinking.
In conclusion, parental factors and the index of newborns indeed have an influence on the health of 36-month-old children.

並列關鍵字

birth cohort study ； parental factors ； child health

參考文獻

18. Tsai TS, Chen JY, Lee MC. Reproductive outcome and infant health in adolescent pregnancy in Taichung City. Acta Paediatr Tw 2001;42:151-7.

38. Chen PC, Li CY, Lin RS, Sung FC. Maternal smoking, environmental tobacco smoking and low birthweight. Taiwan J Public Health 2002;21:321-8.

52. Chen PC, Patricia ED, Lu P, Wang JD. Parental socioeconomic status and low birthweight, preterm delivery, and small for gestational age in Taiwan. Chin J Public Health (Taipei) 1999;18:105-15.

56. Shiau SJ, Huang YJ, Yen LL. Family live events, maternal mental health status, and the problems of preschool children’s behavior-a correlation study. Kaohsiung J Med Sci 1995;11:274-81.

73. Lu JF, Tseng HM, Tsai YJ. Assessment of Health-related Quality of Life in Taiwan (I): Development and Psychometric Testing of SF-36 Taiwan Version. Taiwan J Public Health. 2003;22:501-11.