食盐加碘对贫困农村地区0~35月龄儿童早期发展的影响  

Effect of household using iodized salt on early childhood development in children younger than 35 months in poor rural China

作　　者：吴天晨 石慧峰[1] 张敬旭 魏乾伟 张翠红 郭素芳 赵春霞 王晓莉[1,4] WU Tianchen;SHI Huifeng;ZHANG Jingxu;WEI Qianwei;ZHANG Cuihong;GUO Sufang;ZHAO Chunxia;WANG Xiaoli(Department of Maternal and Child Health, Peking University School of Public Health, Beijing 100191, China)

机构地区：[1]北京大学公共卫生学院妇幼卫生学系,100191 [2]首都医科大学附属北京妇产医院北京妇幼保健院,100123 [3]联合国儿童基金会驻中国办事处,北京100600 [4]国家卫生健康委员会生育健康重点实验室,100191

出　　处：《中国生育健康杂志》2022年第1期1-7,共7页Chinese Journal of Reproductive Health

基　　金：联合国儿童基金会项目(0860/A0/05/502 Health&Nutrition Grant)。

摘　　要：目的探究食盐加碘与贫困农村地区0~35月龄儿童早期发展的关系方法以儿童早期综合发展项目贫困农村地区0~35月龄儿童为调查对象,询问家庭碘盐食用情况,并采用《年龄与发育进程问卷》评价儿童早期发展水平。采用中介效应模型分析家庭食用碘盐是否影响看护人抑郁、儿童喂养和养育行为,进而影响儿童早期发展。结果共纳入0~35月龄儿童2591人,其中家庭使用非碘化盐的儿童59人,占2.3%。家庭食用非碘化盐的儿童可疑发育迟缓率为62.7%,显著高于家庭食用碘盐儿童(32.5%)。Logistic回归结果显示家庭食用非碘化盐的儿童可疑发育迟缓患病风险显著高于食用碘盐儿童(OR=1.81,95%CI:1.01~3.23)。中介效应分析显示家庭食用非碘化盐可以显著增加看护人抑郁风险,降低儿童拥有玩具和对儿童早期学习的支持,进而增加儿童可疑发育迟缓风险。结论家庭食用碘化盐通过改善看护人心理状态和促进适宜的养育看护行为,从而对儿童早期发展具有显著保护作用。Objective To explore the association of household iodized salt consumption with early childhood development(ECD)in children aged 0~35 months in poor rural areas.MethodsChildren aged 0~35 month in poor rural areas where Integrated Early Childhood Development(IECD)program implemented was enrolled as the participants before initiation of the intervention.The information on household iodized salt consumption was collected by a questionnaire.Child development status was evaluated by Ages&Stages Questionnaires Chinese version(ASQ-C).A mediation analysis was conducted to test whether the effect of consuming iodized salt on child development was mediated by caregiver′s mental health and nurturing care practices.ResultsA total of 2591 children aged 0~35 months were enrolled in the study,of which 59(2.3%)were from households consuming non-iodized salt.The prevalence of overall suspected developmental delay in children from households consuming non-iodized salt was 62.7%,which was significantly higher than those from households consuming iodized salt(32.5%).Logistic regression analysis showed that the odds ratio of overall suspected development delay in children from households consuming non-iodized salt compared to those from households consuming iodized salt was 1.81(95%CI:1.01~3.23).The mediation analysis showed that household consuming non-iodized salt significantly increased the risk of depression in caregivers,reduced the likelihood of having toys and supporting for early learning,and then increased the risk of suspected developmental delay(P<0.05).ConclusionHousehold consuming iodized salt has a significant protective effect on early childhood development,which is possibly mediated by improving caregiver′s mental health and nurturing care practices.

关 键 词：儿童早期发展 碘化盐 养育照护 

分 类 号：R17[医药卫生—妇幼卫生保健]