陕南农村地区6~12月龄婴儿贫血的风险因素分析

罗仁福; 梁夏; 刘承芳; 张林秀; 岳爱

doi:10.7499/j.issn.1008-8830.2016.08.013

PDF(1461 KB)

HTML

中国当代儿科杂志 ›› 2016, Vol. 18 ›› Issue (8) : 736-741. DOI: 10.7499/j.issn.1008-8830.2016.08.013

论著·临床研究

陕南农村地区6~12月龄婴儿贫血的风险因素分析

罗仁福^1,3, 梁夏^1,2, 刘承芳^1,3, 张林秀¹, 岳爱⁴

作者信息 +

Risk factors for anemia in infants aged 6-12 months from rural areas of southern Shaanxi Province, China

LUO Ren-Fu^1,3, LIANG Xia^1,2, LIU Cheng-Fang^1,3, ZHANG Lin-Xiu¹, YUE Ai⁴

Author information +

文章历史 +

摘要

目的探讨陕南农村地区6~12月龄婴儿的贫血发生情况及其风险因素。方法采用问卷调查方法收集陕南农村地区6~12月龄婴儿的个人和家庭基本情况、喂养行为信息，并测定血红蛋白含量。采用多因素logistic逐步回归法分析婴儿贫血发生的风险因素。结果共有1802例婴儿及其家庭参与该调查，有效样本1770例。婴儿贫血检出865例（48.87%，865/1770）。多因素logistic逐步回归分析显示，生后一直母乳喂养（多未科学添加辅食）增加婴儿患贫血的风险（OR=1.768，P < 0.01）；辅食添加符合WHO推荐的最小进餐频率标准（OR=0.779，P < 0.05）及使用配方奶喂养（OR=0.658，P < 0.01）是婴儿贫血的保护因素。结论在陕南农村地区6~12月龄婴儿贫血依然是严重的公共卫生问题。喂养不当会增加婴儿贫血的风险，减少婴儿贫血的关键是科学添加辅食。

Abstract

Objective To investigate the prevalence of anemia and related risk factors in infants aged 6-12 months from rural areas of southern Shaanxi Province. Methods A questionnaire survey was used to collect the basic information on infants aged 6-12 months and their families from rural areas of southern Shaanxi Province, China. The content of hemoglobin was measured in these infants. A multivariate logistic stepwise regression analysis was performed to determine the risk factors for the development of anemia in infants. Results A total of 1 802 infants and their families participated in the survey, and there were 1 770 valid samples. A total of 865 infants (865/1 770, 48.87%) were found to have anemia. The multivariate logistic stepwise regression analysis showed that breastfeeding after birth (lack of scientific supplementary food) increased the risk of anemia in infants (OR=1.768, P < 0.01). Addition of supplementary food which met the criteria for minimum feeding frequency recommended by WHO (OR=0.779, P < 0.05) and formula milk feeding (OR=0.658, P < 0.01) were protective factors against anemia in infants. Conclusions In the rural areas in southern Shaanxi Province, anemia in infants aged 6-12 months is still a serious public health problem. Improper feeding can increase the risk of anemia in infants, and scientific addition of supplementary food is the key to reducing anemia in infants.

导出引用

罗仁福, 梁夏, 刘承芳, 张林秀, 岳爱. 陕南农村地区6~12月龄婴儿贫血的风险因素分析[J]. 中国当代儿科杂志. 2016, 18(8): 736-741 https://doi.org/10.7499/j.issn.1008-8830.2016.08.013

LUO Ren-Fu, LIANG Xia, LIU Cheng-Fang, ZHANG Lin-Xiu, YUE Ai. Risk factors for anemia in infants aged 6-12 months from rural areas of southern Shaanxi Province, China[J]. Chinese Journal of Contemporary Pediatrics. 2016, 18(8): 736-741 https://doi.org/10.7499/j.issn.1008-8830.2016.08.013

参考文献

[1] McLean E,Cogswell M,Egli I,et al.Worldwide prevalence of anaemia,WHO Vitamin and Mineral Nutrition Information System,1993-2005[J].Public Health Nutr,2009,12(4):444-454.
[2] Balarajan Y,Ramakrishnan U,ÖZaltin E,et al.Anaemia in low-income and middle-income countries[J].Lancet,2011,378(9809):2123-2135.
[3] 《中华儿科杂志》编辑委员会,中华医学会儿科学分会血液学组,中华医学会儿科分会儿童保健学组.儿童缺铁和缺铁性贫血防治建议[J].中国儿童保健杂志,2010,18(8):724-726.
[4] 常素英,何武,贾凤梅,等.中国儿童营养状况15年变化分析-5岁以下儿童营养状况[J].卫生研究,2007,36(2):210-212.
[5] 赵慧君.儿童缺铁和缺铁性贫血的防治[J].实用儿科临床杂志,2012,27(3):163-165.
[6] 梁颖,赵亚茹.轻度缺铁性贫血对婴幼儿智能及行为发育影响的研究[J].中国实用儿科杂志,2002,17(12):738-740.
[7] 彭春荣,静进,廖军娟.缺铁性贫血对婴幼儿智能发育的影响[J].中国儿童保健杂志,2011,19(4):331-333.
[8] 雷庆龄,戴碧涛,宪莹,等.儿童营养性缺铁性贫血的危险因素分析[J].中国当代儿科杂志,2014,16(1):16-19.
[9] 中国儿童铁缺乏症流行病学调查协作组.中国7个月~7岁儿童铁缺乏症流行病学的调查研究[J].中华儿科杂志,2004,42(12):886-891.
[10] Lozoff B,Jimenez E,Hagen J,et al.Poorer behavioral and developmental outcome more than 10 years after treatment for iron deficiency in infancy[J].Pediatrics,2000,105(4):E51.
[11] 邵洁.胎婴儿期合理铁营养与儿童大脑发育[J].中国实用儿科杂志,2015,30(12):892-896.
[12] 黄忠炎,陈勇,孙佳,等.1658例婴幼儿缺铁性贫血调查分析[J].中国妇幼保健,2015,30(2):266-269.
[13] 郭宏霞,曾果,张倩.铁缺乏与儿童智力的研究进展[J].卫生研究,2012,41(1):137-139.
[14] 张继国,张兵,杜文雯,等.2009年中国西部6省区贫困农村5岁以下儿童贫血状况分析[J].中华流行病学杂志,2011,32(9):902-904.
[15] 王蕾,苏潇歌,王超,等.我国中西部4省(自治区)农村3岁以下儿童贫血状况及其影响因素分析[J].中国健康教育,2013,29(5):390-393.
[16] WHO/UNICEF/USAID.Indicators for assessing infant and young child feeding practices (part I-definitions)[S].Geneva:World Health Organization,2008.
[17] WHO/UNICEF/USAID.Indicators for assessing infant and young child feeding practices (part Ⅱ-measurement)[S].Geneva:World Health Organization,2010.
[18] WHO Multicentre Growth Reference Study Group.WHO Child Growth Standards:Length/Height-for-Age,Weight-for-Age,Weight-for-Length,Weight-for-Height and Body Mass Index-for-Age:Methods and Development[S].Geneva:World Health Organization,2006.
[19] Centers for Disease Control and Prevention.Recommendations to prevent and control iron deficiency in the United States[J].MMWR Recomm Rep,1998,47(RR-3):1-29.
[20] 郭霞,高举.儿童贫血的诊断思路[J].中国实用儿科杂志,2014,29(11):805-810.
[21] WHO/UNICEF/UNU.Iron deficiency anaemia:assessment,prevention,and control.A guide for programme managers[S].Geneva:World Health Organization,2001.
[22] 刘爽,李骏,龚晨睿,等.湖北农村地区6~23月龄婴幼儿贫血状况分析[J].中国公共卫生,2014,30(7):899-902.
[23] 卫生部.中国妇幼卫生事业发展报告(2011)[J].中国妇幼卫生杂志,2012,3(2):49-58.
[24] 朱宗涵.生命最初1000天:改变一生,改变未来[J].中国儿童保健杂志,2011,19(8):681-682.
[25] 崔颖,瞿群,杨丽,等.中国西部农村3岁以下儿童贫血状况分析[J].中国公共卫生,2008,24(9):1052-1053.
[26] 孟丽萍,付萍,张坚,等.陕西镇安县36月龄以下婴幼儿营养与健康状况调查[J].中国儿童保健杂志,2011,19(11):983-985.
[27] 王玉英,陈春明,何武.关于建立中国农村6~23月龄婴幼儿喂养指数的分析[J].卫生研究,2009,38(3):304-306.
[28] 孙倩倩,王俊丽,薛敏波,等.不发达地区农村6至8月龄婴幼儿喂养指数的横断面调查与其生长发育的相关性研究[J].中国循证儿科杂志,2009,4(6):499-503.
[29] 廖志梅,郝国平.6月~36月婴幼儿缺铁性贫血相关因素分析[J].中国医疗前沿,2011,6(23):43-45.
[30] 徐康,张翠梅,王连红,等.6~12月龄婴儿缺铁性贫血的危险因素分析及对神经心理发育的影响[J].中国当代儿科杂志,2015,17(8):830-836.
[31] Meinzen-Derr JK,Guerrero ML,Altaye M,et al.Risk of infant anemia is associated with exclusive breast-feeding and maternal anemia in a Mexican cohort[J].J Nutr,2006,136(2):452-458.
[32] Gong YH,Ji CY,Zheng XX,et al.Correlation of 4-month infant feeding modes with their growth and iron status in Beijing[J].Chin Med J (Engl),2008,121(5):392-398.
[33] Mello-Neto J,Rondó PH,Morgano MA,et al.Iron concentrations in breast milk and selected maternal factors of human milk bank donors[J].J Hum Lact,2010,26(2):175-179.
[34] 李娜,张巍.纯母乳喂养婴儿的缺铁问题研究进展[J].中国儿童保健杂志,2011,19(11):999-1001.
[35] 王丽娟,李文仙,孙静,等.甘肃省贫困县6~23月龄婴幼儿喂养状况调查[J].卫生研究,2011,40(3):327-330.
[36] 陈春明,葛可佑.中国膳食营养指导[M]//何志谦,杨月欣.喂养孩子的科学(第5分册).北京:华夏出版社,2000:257-261.
[37] 钱兴国,谭丽莎,梁可容.不同喂养方式对婴儿生长发育和常见病的影响[J].中国初级卫生保健,2003,17(1):71-72.
[38] 杨振宇,赖建强,汪之顼,等.辅食添加对婴幼儿贫血的影响[J].中国儿童保健杂志,2011,19(11):986-988.
[39] 林良明,宋小芳,刘玉琳,等.中国儿童维生素A缺乏与贫血关系分析[J].中国儿童保健杂志,2003,11(4):242-244.