湖南省六岁以下儿童营养不良现状及影响因素分析  

Prevalence and associated factors for malnutrition among children under 6 years of age in Hunan province

作　　者：李辉霞[1] 黄广文[1] 王华[1] 刘娜[2] 吴静[2] 彭中华 黄群[1] 王爱华[1] Li Huixia;Huang Guangwen;Wang Hua;Liu Na;Wu Jing;Peng Zhonghua;Huang Qun;Wang Aihua(Department of Child Health Care,Hunan Provincial Maternal and Child Health Care Hospital,Changsha 410008,China;Department of Endocrinology,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Maternal and Child Health,Hunan Provincial Health Commission,Changsha 410008,China)

机构地区：[1]湖南省妇幼保健院儿童保健科,长沙410008 [2]中南大学湘雅医院内分泌科,长沙410008 [3]湖南省卫生健康委员会妇幼健康处,长沙410008

出　　处：《中华儿科杂志》2021年第9期759-766,共8页Chinese Journal of Pediatrics

基　　金：湖南省卫生健康委项目(20201924)。

摘　　要：目的:了解湖南省6岁以下儿童营养不良状况,并探讨其影响因素。方法:采用横断面研究。2019年8—11月采用多阶段分层整群抽样和系统抽样相结合的方法在湖南省抽取24个区(县)48个街道(乡镇)144个社区(村)的10442名0~71月龄儿童为调查对象。采用统一制定的调查问卷来收集儿童、看护人、家庭基本情况及其母亲妊娠期情况,采用统一的仪器测量所有儿童的身长(身高)和体重。分别计算身长(身高)/年龄、体重/年龄、体重/身长(身高)、体重指数/年龄Z评分来评估儿童的生长迟缓率、低体重率和消瘦率。不同特征儿童营养不良患病率比较采用χ^(2)检验。采用多因素Logistic回归模型进行儿童营养不良多因素分析。结果:6岁以下儿童蛋白质-能量营养不良患病率为6.8%(710/10442),其中生长迟缓率、低体重率和消瘦率分别为3.1%(328/10442)、2.7%(280/10442)和3.3%(343/10442)。农村地区(OR=1.60)、儿童年龄越大(与0~11月龄相比,12~23、24~35、36~47、48~59、60~71月龄的OR分别为1.42、1.75、1.55、1.70、1.88)、低出生体重(OR=2.72)、看护人民族为少数民族(OR=1.95)和家庭总人口数越多(OR=1.25)是儿童蛋白质-能量营养不良的危险因素。农村地区和低出生体重是儿童生长迟缓的危险因素(OR=2.13、3.28)。农村地区、低出生体重、看护人民族为少数民族和家庭总人口数多是儿童低体重的危险因素(OR=2.57、3.34、1.86、1.32)。农村地区(OR=1.43)、儿童月龄越大(与0~11月龄相比,24~35、36~47、48~59、60~71月龄的OR分别为1.63、1.80、1.84、2.17)、低出生体重(OR=2.36)、看护人民族为少数民族(OR=2.88)和家庭总人口数多(OR=1.42)是儿童消瘦的危险因素。而看护人学历高是儿童蛋白质-能量营养不良、生长迟缓和低体重共同的保护因素(OR=0.85、0.76和0.82)。结论:湖南省6岁以下儿童生长迟缓率、低体重率和消瘦率均处于较低水平,但仍存在Objective To analyze the prevalence and associated factors of malnutrition among children under 6 years of age in Hunan province.Methods This study was a cross-sectional study.A combination of multistage stratified cluster sampling and systematic sampling approach was used to recruit 10442 children aged 0-71 months from 144 communities(villages)across 48 streets(towns)in 24 districts(counties)from Hunan province between August and November 2019.Data concerning the children and their mothers,caregivers,and family conditions was collected using unified questionnaire,with the lengths/heights and weights of the children being measured using unified instruments.The length/height for age,weight for age,weight for length/height,and body mass index for age Z scores were calculated and used to evaluate the prevalence of children′s stunting,underweight,and wasting.The chi-square test was used to compare the prevalence of malnutrition among children with different characteristics.The multivariate Logistic regression model was used to conduct multivariate analysis for childrens′malnutrition.Results The prevalence of protein-energy malnutrition(PEM)among children under 6 years of age was 6.8%(710/10442),and the prevalence of stunting,underweight,and wasting were 3.1%(328/10442),2.7%(280/10442),and 3.3%(343/10442),respectively.Rural areas(OR=1.60),older age of children(compared with children of 0-11 months,the OR for 12-23,24-35,36-47,48-59,and 60-71 months were 1.42,1.75,1.55,1.70,and 1.88,respectively),low birth weight(OR=2.72),caregivers of minority ethnicity(OR=1.95),and large family size(OR=1.25)were risk factors for children′s PEM.Rural areas and low birth weight were risk factors for stunting in children(OR=2.13 and 3.28).Rural areas,low birth weight,caregivers of minority ethnicity,and large family size were risk factors for underweight in children(OR=2.57,3.34,1.86,and 1.32).Rural areas(OR=1.43),older age of children(compared with children of 0-11 months,the OR for 24-35,36-47,48-59,and 60-71 months were 1.63,1.

关 键 词：儿童 营养不良 生长迟缓 低体重 消瘦 影响因素 

分 类 号：R723[医药卫生—儿科]