Association between sleep patterns at 12 months of age and behavioral problems at 6 years of age in children
Objective To explore relationship between children's sleep patterns at age of 12 months and their behavioral problems at age of 6 years.Methods In this prospective cohort study based on The Born in Guangzhou Cohort Study(BIGCS)started in 2012,the children who were born between May 2012 and December 2016,and participated in the BIGCS and received regular face-to-face follow up to 6 years old were included.Brief Infant Sleep Questionnaire(BISQ)was used to collect the infants'sleep information at their 12 months of age,and Strengths and Difficulties Questionnaire(parent version)(SDQ)was used to assess children's behavioral problems at their 6 years of age.According to such variables as nighttime sleep duration and time point of falling asleep at night in the sleep information of the infants at their 12 months of age,in Hierarchical K-means clustering method,an infant's sleep pattern was constructed.Binary Logistic regression model was used to analyze relationship between infant's sleep patterns at 12 months of age and risk of behavioral problems at 6 years of age in children.Results A total of 1 480 children were included in this study.Four infant sleep patterns were constructed,including less-early sleep pattern(n=562,37.97％),less-late sleep pattern(n=322,21.76％),median-late sleep pattern(n=345,23.31％),and more-early sleep pattern(n=251,16.96％).Among 6 dimensions of children's behavioral problems,the incidence rate of difficult behavioral problems was the highest,accounting for 9.53％,the incidence rate of conduct problems was the second,accounting for 8.85％and the incidence rate of emotional symptoms was the third,accounting for 8.24％.Multi-factor Logistic regression shown that after adjusting for such factors as parental educational levels,maternal smoking exposure during pregnancy,maternal anxiety and depression levels during pregnancy,maternal postpartum depression level,and child's gender,birth weight Z scores based on gestational age and gender,feeding pattern at 0-6 months of age,secondhand smoke exposure in infancy and allergy,if the more-early sleep pattern was regarded as the reference,at 6 years of age,the risk of occurrence of peer interaction problems of the children whose sleep pattern was the median-late sleep pattern at 12 months of age increased(OR=2.434,95％CI:1.198-4.943,P=0.014).There were no statistically significant associations of the less-early sleep pattern and the less-late sleep pattern at 12 months of age with incidence risks of emotional symptoms,conduct problems,hyperactivity/attention deficiency behavioral problems,peer interaction behavioral problems,prosocial behavioral problems and difficult behaviors at 6 years of age in the children(all P＞0.05).Conclusion The median-late sleep pattern at age of 12 months may be a risk factor for peer interaction problems at age of 6 years in children.Correcting poor sleep patterns in infancy may be a new target for early prevention and intervention of children's behavioral problems.
infant sleepsleep patternchild behaviorcohort study
万方数据
维普
