安徽省2周岁内母乳与非母乳喂养儿童血清维生素A水平比较分析  

Differences in serum retinol level between the breastfed and non-breastfed children aged 0 to 23 months

作　　者：张业武[1] 陶芳标[2] 尹惠萍[3] 朱晓明[3] 计国平[3] 孔圣华[3] 宋清华[3] 陈建华[3] 储诚志[3] 李竹[1] 

机构地区：[1]北京大学生育健康研究所,100083 [2]安徽省医科大学儿少卫生和妇幼卫生系 [3]安徽省妇幼保健所

出　　处：《中华流行病学杂志》2006年第4期302-306,共5页Chinese Journal of Epidemiology

摘　　要：目的了解母乳与非母乳喂养儿童中血清维生素A水平是否存在差异以及造成差异可能原因。方法研究数据来自人群为基础的儿童维生素A营养状况横断面调查,共调查401名 0-23月龄儿童。采用改良的荧光方法测定血清中视黄醇含量来反映维生素A水平,通过问卷方法调查儿童的家庭社会经济、围产期保健、2周内患病情况;半定量膳食频率问卷调查前1周内儿童膳食情况。利用SAS 8．1软件进行统计分析。结果 401名2岁内儿童中,母乳喂养率为50．37％;非母乳喂养组维生素A平均水平为(30．67±0．57)μg／dl,母乳喂养组为(27．60±0．56)μg/dl,两组差异有统计学意义(P<0．01);在控制其他因素影响后,调整后的非母乳喂养组均值为(31．82±0．98)μg／dl, 母乳喂养组为(29．46±0．96)μg／dl,差异有统计学意义(P<0．01)。按年龄组分层分析显示,0月龄～、6月龄～、12月龄～和18月龄～组的母乳喂养率分别92．1％、70．1％、32．0％和17．1％。各年龄组内两组间(非母乳喂养组-母乳喂养组)维生素A均值差值及其95％可信区间(CI)分别为4．70 (-2．52-1.92)、0．82(-2.32-3．95)、2．95(-0．68-6．58)和6．05(2．34-9．77)μg／dl;控制其他混杂因素后,调整后的两组均值差值及其95％CI分别为0．00(-7．18-7．19)、1．35(-1．76-4．45)、 2．92(-0．82-6．65)和4.26(0．71-7．81)μg/dl;调整前、后只有18月龄组非母乳喂养组和母乳喂养组维生素A水平差异有统计学意义(P<0．01)。趋势x2检验表明12月龄以后母乳喂养儿童辅食添加频率均比非母乳喂养儿童低。结论与非母乳喂养儿童相比,母乳喂养儿童的体内维生素A水平有所降低,但差别只是局限在18月龄以后儿童中。母乳中维生素A含量不足以及辅食添加不充分可能是造成这种差异潜在原因。控制人群中维生素A缺乏应该采取综合干预措施。Objective Some recent studies found that high prevalence of vitamin A deficiency in the breastfed children. This study aimed to understand the differences in serum retinol level between breastfed and bottle fed children aged 0 to 23 months and the possible causes of low level of serum retinol for the breastfed children. Methods Data for children aged 0 to 23 months were extracted from a population-based cross sectional study for vitamin A nutrition status. Fluorescence method was used to measure the serum retinol. Mothers or caregivers were asked to answer a pre designed questionnaire and socioeconomic status, perl-natal care, breastfeeding status, morbidity histories and other related factors were collected. Semi- quantitative food frequency questionnaire was used to investigate the child＇s dietary ~ntake one week prior to the survey. Data were analyzed using SAS 8. 1. Results Of 401 children aged 0 to 23 months, the breastfeeding rate was 50.37%. The means of the serum retinol level between bottle-fed （30.67± 0.57） μg/dl and the breastfed children （27.60± 0.56）μg/dl was significantly different （P〈 0.01）. The corresponding figures were （ 31.82± 0.98 ） μg/dl and （ 29.46± 0.96） μg/dl after adjustment for confounders, which also showed significant difference（P〈 0.01）. After stratified by age groups, the breastfeeding rates in the 0-, 6-, 12- and 18 months groups were 92.1% , 70.1%, 32.0 % and 17.1%, respectively. We calculated the difference in means of the serum retinol level between the bottle-fed and breastfed children for each of four age groups, and the 95% confidencelimits of the differences. The differences in means and the 95 % confidence limits for 0-, 6-, 12- and 18 months group were 4.70 μg/dl （ 2.52-1.92）,0.82μgg/dl（ 2. 32- 3. 95 ） , 2 . 95 μg/dl （ - 0. 68- 6. 58 ） and 6. 05 μg/dl （ 2. 34- 9. 77 ） , respectively. After adjustment for confounders and covariates, the adjusted figures were 0.00 μgg/dl（ - 7.18- 7.19）, 1.35 μg/dl （ - 1.76-4.45

关 键 词：母乳喂养 维生素A缺乏 辅食添加 

分 类 号：R179[医药卫生—妇幼卫生保健]