中国中西部8县母亲孕期贫血与儿童发育迟缓的关联性研究

Analysis of correlation between maternal anemia during pregnancy and developmental delay among children in 8 counties in central and western China

目的了解中国中西部8县的母亲孕期贫血状况,并探讨其与儿童发育迟缓的关联性,为相关干预措施提供依据。方法 2016年10月-2017年1月采用横断面研究和按容量比例概率抽样法,调查了中国中西部地区8个县的1 100名1～59月龄儿童母亲孕期贫血状况,使用年龄与发育进程问卷(ASQ)评价儿童发育状况。运用多因素Logistic回归分析,计算调整混杂因素后的比值比(OR)和95%置信区间(95%CI)。结果被调查地区儿童母亲孕期贫血患病比例为38.1%。控制了儿童性别、月龄、孩次、分娩方式、出生胎龄、出生体重、营养不良、儿童贫血、家庭年人均纯收入及母亲文化程度等因素后,孕期贫血是儿童沟通能区(OR=2.02,95%CI:1.09～3.75,P=0.025)和ASQ总评分(OR=1.63,95%CI:1.12～2.38,P=0.011)的可疑发育迟缓的危险因素。结论被调查地区儿童母亲孕期贫血与儿童可疑发育迟缓的发生存在关联。

Objective To understand the status of maternal anemia during pregnancy,and to explore its correlation with developmental delay among children in 8 counties in central and western China,in order to provide evidence for intervention. Methods A cross-sectional study with probability proportional to size(PPS) sampling method was conducted in 8 counties in central and western China from October 2016 to January 2017. Data of maternal anemia during pregnancy of 1 100 children aged 1-59 months were obtained. Ages and Stages Questionnaires(ASQ) were used to evaluate the developmental outcomes of children. Multivariate Logistic regression model was applied to estimate the odds ratios(OR) and 95% confidence intervals(95%CI) after adjustment for potential confounding variables. Results Totally 419(38.1%) mothers had maternal anemia during pregnancy in surveyed areas. Maternal anemia during pregnancy was a risk factor for suspected developmental delay in communication domain(OR=2.02,95%CI:1.09-3.75,P=0.025) and overall ASQ(OR=1.63,95%CI:1.12-2.38,P=0.011) after adjustment for children′s gender,children′s age,parity,delivery mode,gestational age,birth weight,malnutrition,anemia in children,annual per capita net income of the family and maternal education. Conclusion Maternal anemia during pregnancy is correlated with suspected developmental delay among children in in central and western China.