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

Analysis on anemia status and its influence factors among rural children under 3 years old in 4 provinces of Midwest China

目的了解我国中西部农村地区儿童的贫血状况,并对其影响因素进行分析。方法采用多阶段分层随机抽样方法,筛选出1272名3岁以下儿童对其家庭进行问卷调查及血红蛋白测定。所得资料进行χ2检验和Logistic回归分析。结果 3岁以下儿童贫血患病率为46.3%,6～12月龄为3岁以下儿童贫血患病率的高峰,以后贫血患病率随月龄增加而下降。单因素分析显示儿童民族、看护人、体重低下、生长迟缓、过去2周内腹泻、母亲贫血、6个月龄内喂养方式、辅食添加种类(配方奶粉、普通牛奶、铁米粉、动物肉类、水产品)及辅食添加方式与3岁以下儿童贫血有统计学关联。多因素Logistic回归分析显示体重低下(OR=1.581,95%CI:0.967～2.586)、过去2周内腹泻(OR=2.143,95%CI:1.453～3.160)和母亲贫血(OR=2.211,95%CI:1.611～3.036)均是儿童贫血的危险因素,6个月龄内混合喂养(OR=2.184,95%CI:1.561～3.055)和人工喂养方式(OR=5.282,95%CI:2.507～11.131)相对于母乳喂养是儿童贫血的危险因素;而添加普通牛奶(OR=0.721,95%CI:0.524～0.991)和添加铁米粉(OR=0.599,95%CI:0.496～1.055)是儿童贫血的保护因素。结论我国中西部农村地区3岁以下儿童贫血患病率较高,应开展多种形式的健康教育、加强农村儿童系统保健管理,积极防治儿童常见病、多发病等将有助于改善儿童贫血状况。

Objective To analyze the anemia status and its influence factors among rural children under 3 years old in Midwest China.Methods The 1272 children under 3 years old and their families were selected by using multi-staged stratified random sampling methods.Hemoglobin was measured.Logistic regression analysis was used to analyze the data.Results The prevalence of anemia among the children under 3 years old in investigation areas was 46.3%.The peak of anemia prevalence was at 6-12 months.Then the prevalence of anemia was decreased along with months of age.Univariate analysis showed that infants ethnic,caregivers,underweight,growth retardation,diarrhea in the last two weeks,maternal anemia,feeding pattern in the first 6 months,supplementary food types（formula milk powder,milk,iron rice flour,animal meat and water products） and food supplement methods were significantly statistical associated with anemia among children under 3 years old.The analysis of logistic regression showed that underweight（OR=1.581,95%CI：0.967-2.586）,diarrhea in the last two weeks（OR=2.143,95%CI：1.453-3.160）,maternal anemia（OR=2.211,95%CI：1.611-3.036） were the risk factors of children＇ s anemia,mixed feeding（OR=2.184,95%CI：1.561-3.055） and artificial feeding（OR=5.282,95%CI：2.507-11.131） in the first 6 months were the risk factors of children＇ s anemia with respect to breastfeeding,while adding milk（OR=0.721,95%CI：0.524-0.991）,adding iron rice flour（OR=0.599,95%CI：0.496-1.055） were protective factors of children＇ s anemia.Conclusion The prevalence of anemia among rural children under 3 years old in Midwest China was high.It would be help for improving the anemia status to carry out health education in various forms,strengthen rural children health care management system,and treat common children diseases.