儿童体检门诊中婴幼儿营养性缺铁性贫血的现状及危险因素分析

Analysis of the status and risk factors of nutritional iron deficiency anemia in infants and young children in children′s physical examination clinic

目的分析儿童体检门诊中婴幼儿营养性缺铁性贫血的现状及危险因素。方法回顾性分析2018年1月~2019年10月本院儿童体检门诊收治的200例婴幼儿的一般资料,对所有入选婴幼儿均行营养性缺铁性贫血检查。分析不同喂养方式、不同年龄段、不同性别婴幼儿营养性缺铁性贫血发生情况,并对婴幼儿营养性缺铁性贫血发生的危险因素进行分析。结果母乳喂养的婴幼儿营养性缺铁性贫血发的生率高于混合喂养的婴幼儿,差异有统计学意义(P<0.05);6~12个月的婴幼儿营养性缺铁性贫血的发生率高于>1~2岁的婴幼儿,差异有统计学意义(P<0.05);不同性别的婴幼儿营养性缺铁性贫血的发生率比较,差异无统计学意义(P>0.05);未接受育儿指导的婴幼儿营养性缺铁性贫血的发生率高于接受育儿指导的婴幼儿,差异有统计学意义(P<0.05);城市与乡镇的婴幼儿营养性缺铁性贫血的发生率比较,差异无统计学意义(P>0.05);4~6个月添加辅食与7~9个月添加辅食的婴幼儿其营养性缺铁性贫血的发生率比较,差异无统计学意义(P>0.05);母亲孕期存在贫血的婴幼儿营养性缺铁性贫血的发生率高于母亲孕期不存在贫血的婴幼儿,差异有统计学意义(P<0.05)。多因素回归分析结果显示,母乳喂养(β=2.513,OR=1.021,95%CI=0.864~1.211)、6~12个月龄(β=2.113,OR=1.792,95%CI=0.980~2.126)、未接受育儿指导(β=2.452,OR=1.255,95%CI=1.031~1.722)、母亲孕期贫血(β=2.108,OR=2.346,95%CI=1.933~3.316)是婴幼儿营养性缺铁性贫血的高危因素(P<0.05)。结论给予婴幼儿混合喂养能够减少其营养性缺铁性贫血的发生风险,并且随着婴幼儿年龄的增长营养性缺铁性贫血的发生概率随之降低,同时应在孕期对母体营养状况进行适当干预,并予以育儿指导,以便降低婴幼儿营养性缺铁性贫血发生风险。

Objective To analysis the status and risk factors of nutritional iron deficiency anemia in infants and young children in children′s physical examination clinics.Methods The general information of 200 infants and young children admitted to our children′s physical examination clinic from January 2018 to October 2019 were retrospectively analysised.All the infants and young children were examined for nutritional iron deficiency anemia.The incidence of nutritional iron-deficiency anemia in infants with different feeding methods,different ages and genders were analyzed,and the risk factors for the occurrence of nutritional iron-deficiency anemia in infants and young children were analyzed.Results The incidence of nutritional iron deficiency anemia in breastfed infants was higher than that of mixed-fed infants,and the difference was statistically significant(P<0.05);the incidence of nutritional iron deficiency anemia in infants from 6 to 12 months was higher than that of infants and young children aged>1 to 2,the difference was statistically significant(P<0.05);the incidence of nutritional iron-deficiency anemia in infants of different genders was compared,the difference was not statistically significant(P>0.05);the incidence of nutritional iron-deficiency anemia in infants receiving parenting guidance was higher than that of infants receiving parenting guidance,and the difference was statistically significant(P<0.05);there was no statistically significant difference in the incidence of nutritional iron-deficiency anemia in infants and young children between cities and towns(P>0.05);there was no statistically significant difference in the incidence of nutritional iron-deficiency anemia in infants and young children who were supplemented with complementary foods from 4 to 6 months and from 7 to 9 months(P>0.05);the incidence of nutritional iron-deficiency anemia in infants with anemia during pregnancy was higher than that of infants without anemia during pregnancy, and the difference was statistically significant (P<0.05). The results of multivariate regression analysis showed that breastfeeding (β=2.513, OR=1.021, 95%CI=0.864-1.211), 6 to 12 months of age (β=2.113, OR=1.792, 95%CI=0.980-2.126), no childcare guidance (β=2.452, OR=1.255, 95%CI=1.031-1.722), maternal anemia during pregnancy (β=2.108, OR=2.346, 95%CI=1.933-3.316) were high risk factors for infant nutritional iron deficiency anemia (P<0.05). Conclusion The mixed feeding of infants and young children can reduce the risk of nutritional iron deficiency anemia, and the incidence of nutritional iron deficiency anemia decreases with the age of infants and young children. At the same time, the mother′s nutritional status should be appropriately adjusted during pregnancy. Intervention and parenting guidance should be given to reduce the risk of nutritional iron deficiency anemia in infants and young children.