2014—2019年昆明市5岁以下儿童营养不良状况及影响因素分析

目的 研究昆明市5岁以下儿童的营养不良状况及影响因素,为政府制定相关政策提供依据。 方法 对2014—2019年昆明市国家监测点五华区4个街道体检儿童数据进行分析。采用χ²检验、趋势χ²检验及非条件多因素logistic回归分析儿童营养不良状况及影响因素。 结果 2014—2019年昆明市5岁以下体检儿童低体重发生率为0.29%,生长迟缓发生率为0.46%,消瘦发生率为0.66%,超重发生率为0.50%,肥胖发生率为0.12%,除肥胖率外均存在逐年增长的趋势(P<0.05)。logistic回归分析发现,父母双方或一方在外打工(OR=12.642)、早产儿(OR=2.408)、胎次≥2次(OR=2.900)、纯母乳喂养率低(OR=2.033)、第一次母乳喂养时间滞后(OR=3.153)、家庭人口过多(OR=4.193)、家庭收入较低(OR=3.975~9.278)、母亲妊娠期患病(OR=2.170)均是儿童营养不良发生率增高的危险因素。 结论 昆明市5岁以下儿童的营养不良发生率较低,但仍存在逐年增长的趋势,且1岁以内儿童更容易发生。儿童营养不良与父母外出打工、早产儿、胎次≥2次、纯母乳喂养率低、第一次母乳喂养时间滞后、家庭人口数多、家庭收入低、母亲妊娠期患病情况有关,应采取综合措施来改善儿童营养不良状况。

Status of malnutrition and its influencing factors among children under 5 years of age in Kunming City, 2014-2019

Objective To study the status of malnutrition and its influencing factors among children under the age of 5 years, and to provide a basis for the government to formulate relevant policies. Methods We analyzed the data about children with health check-up from national surveillance sites, 4 streets in Wuhua District of Kunming City from 2014 to 2019. Chi-square test, trend chi-square test and unconditional multivariate logistic regression were used to analyze malnutrition status and its influencing factors in children. Results The incidence rates of underweight, stunting, wasting, overweight and obesity in children under 5 years old in Kunming from 2014 to 2019 were 0.29%, 0.46%, 0.66%, 0.50% and 0.12%, respectively, and all showed an upward trend year by year except the incidence rate of obesity (P<0.05). Logistic regression analysis indicated that both parents or one of them worked outside the home (OR=12.642), premature infants (OR=2.408), parity more than two times (OR=2.900), low rate of exclusive breastfeeding (OR=2.033), lag of first breastfeeding time (OR=3.153), excessive family population (OR=4.193), low family income (OR=3.975-9.278) and maternal illness during pregnancy (OR=2.170) were all the risk factors for increasing the incidence rate of malnutrition in children. Conclusion The incidence rate of malnutrition among children under 5 years old in Kunming City from 2014 to 2019 was low, but still showed an upward trend year by year, and children under 1 year were susceptible to malnutrition. Children’ malnutrition was related to parents worked outside the home, premature infants, parity more than two times, low rate of exclusive breastfeeding, lag of first breastfeeding time, excessive family population, low family income and maternal illness during pregnancy. It is necessary to take comprehensive measures to improve the status of malnutrition in children.