中国0～6岁儿童营养性贫血影响因素meta分析

Influencing factors of nutritional anemia in 0–6 years old children in China: a meta-analysis

目的探讨中国0~6岁儿童营养性贫血的影响因素,为采取相应的预防控制措施提供参考依据。方法检索中国生物医学期刊文献数据库(CBM)、中国万方数据库、中国知网数据库(CNKI)、维普中文科技期刊全文数据库(VIP)和Pubmed数据库,并辅以手工检索和文献追溯法收集各数据库建库至2015年12月31日公开发表的关于中国0~6岁儿童营养性贫血影响因素的相关文献;应用Stata 11.0统计软件对纳入的文献进行meta分析。结果最终纳入15篇中英文文献(中文文献14篇,英文文献1篇),累计病例组儿童10 846例,对照组儿童31 613人;meta分析结果显示,母亲贫血(OR=1.805,95%CI=1.251~2.603)、辅食添加不及时(OR=1.411,95%CI=1.123~1.772)、营养不良(OR=1.329,95%CI=1.179~1.498)和近期罹患胃肠道疾病(OR=1.798,95%CI=1.409~2.296)是中国0~6岁儿童营养性贫血的危险因素,月龄较大(OR=0.789,95%CI=0.717~0.867)是中国0~6岁儿童营养性贫血的保护因素;敏感性分析和发表偏倚评估结果均显示,纳入的文献不存在发表偏倚,结果较为可靠。结论月龄、母亲是否贫血、辅食添加是否及时、是否营养不良和近期是否罹患胃肠道疾病是中国0~6岁儿童营养性贫血的主要影响因素。

Objective To investigate influencing factors of nutritional anemia in Chinese children aged 0-6 years and to provide evidences for prevention and management of the disease.Methods Studies published till December 31st 2015 on impact factors of nutritional anemia among 0-6 years old children in China were searched through Pubmed, China Biological Medicine （CBM）, WanFang Database, China National Knowledge Infrastructure （CNKI）, and Chongqing VIP database （VIP）. Stata 11.0 software was applied for the meta-analysis.Results For the 15 included studies with totally 10 846 anemic children and 31 613 control children, the pooled odds ratio （OR） and its 95% confidence interval （95% CI） of the factors associated with anemia were 1.805 （1.251-2.603） for maternal anemia, 1.411 （1.123-1.772） for without timely introduction of solid food, 1.329 （1.179-1.498） for malnutrition, 1.798 （1.409-2.296） for suffering gastrointestinal disease recently, and 0.789 （0.717-0.867） for at elder age of month. No publication bias were observed for the studies based on sensitivity analysis and bias estimation, suggesting the results of the meta-analysis is valid.Conclusion Elder age of month, maternal anemia, without timely introduction of solid food, malnutrition, suffering from gastrointestinal disease during recent time are the risk factors of nutritional anemia among 0-6 years old children in China.