Objective: To observe the development of the anterior fontanel (AF) in healthy Chinese children from 1 to 36 months, and to assess the relationship between the closure of the AF and physical development in Chinese children. Method: This was a cross-sectional evaluation of the AF in a series of 104 147 healthy children between June 2015 and October 2015 from nine cities in China. The size and closure of AF of the children were measured and recorded, and the age for the closure of AF was calculated using probit analysis. The data in 2015 were compared with the data from the same surveys in 1985, 1995 and 2005 respectively. Result: (1) Totally, 104 147 healthy children (52 216 boys and 51 931 girls; range 1 month to 36 months) from nine cities enrolled in this cross-sectional study. (2)The size of AF gradually decreased with age, and the mean size of AF was 2.0(95% confidence interval (CI)2.0-2.1) cm at the age of 1 month, 0.6(95% CI 0.5-0.6) cm at the ages of 12-14 months, and 0.0(95% CI 0.0-0.0) cm at the ages of 21-23 months, respectively. (3) The percentage for the closure of AF was 0.1% at the age of 3 months, 67.5% at the ages of 15-17 months. The oldestt age for closure was 35 months. The mean age for the closure of AF was 14.5 months (95% CI 14.4-14.6), and the 3rd and 97th centiles of the age for the closure of AF were 6.6 and 22.4 months. (4) Over the past 30 years from 1985 to 2015, no significant change was found regarding the mean age for the closure of AF in children from urban area, contrarily, the mean age was 1.1 months earlier in suburban area. (5) The height and weight of children in the closed AF group were significantly higher than those of children in unclosed AF group(all P<0.01), but no significant difference was found regarding the head circumference between the two groups. Conclusion: The size of AF at 1 month was maximum, then decreases gradually with age, and the mean age for the closure of AF was 14.5 (95% CI 14.4-14.6) months. No significant correlation was found between the development of AF and the head circumference, but there was a positive correlation between the development of AF and the height and weight. There was no significant change regarding the secular trend of the age for the closure of AF.
目的： 探讨我国婴幼儿前囟发育现状及其变化趋势，分析前囟的闭合与体格发育指标之间的关系。 方法： 采用横断面研究方法，于2015年6—10月在北京、哈尔滨、西安、上海、南京、武汉、广州、福州、昆明九市进行，以1～36月龄健康婴幼儿为研究对象，通过测量前囟大小和检查前囟是否已闭合来获得前囟发育的相关信息，应用probit概率单位回归方法计算前囟闭合时间。通过与1985、1995和2005年的调查数据比较，探讨婴幼儿前囟发育的变化趋势。采用t检验方法比较前囟闭合与否两组体格指标的差异。 结果： (1)九市共调查1～36月龄健康婴幼儿104 147名，其中男童52 216名，女童51 931名。(2)前囟大小变化规律：前囟大小随年龄增长逐渐缩小，从1月龄的2.0[95%可信区间(CI)2.0～2.1] cm，至12 ～14月龄的0.6(95%CI 0.5～0.6) cm，21～23月龄的0.0(95%CI 0.0～0.0) cm。(3)前囟闭合时间：3月龄组有0.1%(6/7 452)的婴儿前囟闭合，15～17月龄组有67.5%(5 027/7 448)的婴幼儿前囟闭合，最晚35月龄闭合。前囟平均闭合时间为14.5(95% CI 14.4～14.6)月龄，闭合时间的第3～97百分位参照范围为6.6～22.4月龄。(4)前囟发育的长期变化：1985—2015年的30年间，前囟闭合的平均时间城区未见明显变化，郊区提前1.1个月。(5)前囟发育与体格指标的关系：前囟未闭合组婴幼儿的头围与已闭合组相比差异无统计学意义，但前囟已闭合组婴幼儿的身长和体重均明显大于未闭合组(P均<0.01)，以6～7月龄男童为例，前囟已闭合组比未闭合组身长高出1.8 cm，体重高0.5 kg。 结论： 我国婴幼儿前囟的大小在1月龄时最大，随后逐渐缩小，平均闭合时间为14.5(95%CI 14.4～14.6)月龄。前囟闭合的早晚与头围之间无明显相关性，但与身长、体重存在正相关。前囟闭合时间未发现明显的长期变化趋势。.
Keywords: Child development; Cranial fontanelles; Secular trend.