甘肃省贫困地区6-24月龄婴幼儿营养不良状况及影响因素分析

发布时间：2018-07-06 15:07

本文选题：婴幼儿 + 生长发育　；参考：《兰州大学》2016年硕士论文

【摘要】：目的了解甘肃省贫困地区6-24月龄婴幼儿喂养以及营养不良现况,探讨和分析与营养不良有关的可能影响因素,为《甘肃省贫困地区儿童营养改善试点项目》的评价提供基线数据,也为政府制定婴幼儿营养不良预防策略和干预措施提供科学依据。方法采用多阶段分层整群抽样方法,结合PPS抽样法(容量比例概率抽样法),确定调查对象。调查对象为样本村家庭6-24月龄婴幼儿及其家长或看护人,共调查了3663对6-24月龄婴幼儿及其家长或看护人。问卷调查法和实验室检测相结合,进行现况流行病学调查,采用《甘肃省贫困地区儿童营养改善试点项目》拟定的儿童基本情况问卷、儿童出生及食物喂养情况问卷、儿童家长喂养与营养知识调查问卷,收集相关的流行病学研究资料;现场采集儿童指尖末梢血,用血红蛋白便携式分析仪快速检测儿童血红蛋白含量;通过婴幼儿智能体检仪现场测量儿童身长和体重值。数据采用Epidata3.1进行双录入,Anthro3.2.2软件计算身长和体重的Z评分值,SPSS20.0软件进行统计分析。使用卡方检验和Fisher确切概率法对营养不良影响因素进行单因素分析;使用非条件logistic回归分析法对营养不良影响因素进行多因素分析。结果(1)调查对象的基本构成情况:①共调查3663名6-24月龄儿童,其中男童1907名(52.1%),女童1756名(47.9%),男女性别比为1.1:1;低出生体重者占3.3%,巨大儿占3.6%;民族分布为:汉族2562名(69.9%),藏族847名(23.1%),回族150名(4.1%),东乡族104名(2.8%);②父母平均年龄分别为28.5±4.7岁(19-50岁)和26.5±4.3岁(16-50岁),均以20-29岁者为主;父母亲文化程度多在初中水平,分别占47.1%和42.7%;父亲以无职业(38.6%)和从事农业劳动(32.5%)为主,母亲以无职业(62.0%)为主,其次是从事农业劳动(19.1%)。(2)婴幼儿看护情况:婴幼儿看护人以母亲为主(75.0%),其次是祖父母(21.5%);《家长喂养与营养知识调查》显示看护人对婴幼儿喂养与营养知识平均得分为1.9±2.3分,及格率仅为16.5%。(3)婴幼儿喂养情况:①婴幼儿6个月内喂养方式以混合喂养为主(60.6%),纯母乳喂养率达到34.7%;②6个月后开始添加辅食的占58.6%,4-5月龄开始添加辅食的占21.1%;③本次调查中,已经添加辅食的婴幼儿占90.8%,尚未添加辅食的婴幼儿占9.2%;摄入配方奶粉的占47.6%;婴幼儿辅食种类以谷类(84.9%)、白心薯类(53.5%)、蛋类(43.7%)为主,肉类、坚果类较少;摄入营养素补充剂的婴幼儿所占比例较低,仅有8.8%;营养素中摄入钙的比例较高,占16.2%,摄入锌的比例最低,仅有5.0%。(4)婴幼儿检测指标:①婴幼儿平均血红蛋白值为11.5±1.6g/dl,59.0%婴幼儿血红蛋白值低于正常值;②婴幼儿营养不良发生率为21.3%,其中超重、消瘦、低体重和发育迟缓率分别为7.0%、4.0%、3.2%和7.1%。(5)婴幼儿营养状况影响因素:①单因素卡方检验结果显示:月龄、性别、贫血状况、是否早产、出生身长和体重、看护人学历和职业、6个月内喂养方式、辅食添加时间、辅食添加种类以及营养素补充情况等与6-24月龄婴幼儿营养不良的发生之间存在相关性。②多因素非条件Logistic回归分析结果显示:影响6-24月龄婴幼儿营养状况的因素有性别、月龄、是否早产、看护人科学喂养知识水平、看护人职业、辅食添加时间和辅食添加种类。结论(1)甘肃省贫困地区6-24月龄婴幼儿生长发育迟缓检出率高于《中国儿童发展纲要(2011—2020年)》的要求(7%以下),超重检出率高于世界平均水平(6%),贫血患病率高达59.0%。超重、贫血是甘肃贫困地区6-24月龄婴幼儿面临的主要营养问题。(2)甘肃省贫困地区6-24月龄婴幼儿6个月内纯母乳喂养率低于《中国儿童发展纲要(2011-2020)》要求水平(50%以上),使6个月内婴幼儿难以获得最优母乳营养,不利于儿童生长发育。(3)甘肃省贫困地区6-24月龄婴幼儿的辅食添加时间、辅食添加种类、辅食添加质量和频率不合理,存在辅食添加时间早、辅食添加种类单一、辅食质量低、喂养频率不合理等问题,不利于婴幼儿生长发育。(4)甘肃省贫困地区婴幼儿营养状况的影响因素包括婴幼儿性别、月龄、是否早产、看护人科学喂养知识水平、看护人职业、辅食添加时间和辅食添加种类。
[Abstract]:Objective to understand the status of feeding and malnutrition of 6-24 months old children in poor areas in Gansu Province, to explore and analyze the possible factors related to malnutrition, to provide baseline data for the evaluation of children's nutritional improvement pilot project in Gansu Province, and to provide the government to formulate prevention strategies and interventions for infant malnutrition. Methods using the multi-stage stratified cluster sampling method and the PPS sampling method (capacity ratio probability sampling) to determine the subjects. The survey subjects were 6-24 months old infants and their parents or caretakers in the sample village families. 3663 pairs of 6-24 month old infants and their parents or caretakers were investigated. Combined with the epidemiological survey, the basic situation questionnaire of children, the questionnaire of children's birth and food feeding, the questionnaire of the feeding and nutrition knowledge of children, the questionnaire of the feeding and nutrition knowledge of the children, and the data of epidemiological studies were collected, and the blood of the fingertips and blood of the children's fingertips were collected and the blood was collected from the children in the Gansu province. The content of children's hemoglobin was detected quickly by a portable erythropoin analyzer. The data of children's body length and weight were measured by the infant intelligent physical examination instrument. The data was recorded by Epidata3.1, and the value of Z for the body length and weight of the children was calculated by Anthro3.2.2 software, and the SPSS20.0 software was analyzed statistically. The chi square test and the exact probability method of Fisher were used. Single factor analysis of the factors affecting malnutrition; multifactor analysis on the factors affecting malnutrition by non conditional logistic regression analysis. Results (1) the basic composition of the respondents was: (1) a total of 3663 children of 6-24 months of age were investigated, including 1907 boys (52.1%), 1756 girls (47.9%), sex ratio of men and women, and low birth weight. The population accounted for 3.3% and the giant children accounted for 3.6%, the ethnic distribution was 2562 (69.9%), 847 Tibetans (23.1%), 150 Hui nationality (4.1%), and 104 (2.8%) of Dongxiang nationality, and the average age of parents was 28.5 + 4.7 (19-50 years) and 2562 years old. With no occupation (38.6%) and engaged in agricultural labor (32.5%), mother was dominated by no occupation (62%), followed by agricultural labor (19.1%). (2) infant care: infant caregivers were mothers (75%), followed by grandparents (21.5%); < family length feeding and Nutrition Knowledge > showed that the nursing and nutrition knowledge of the caregivers was flat. The average score was 1.9 + 2.3 points, and the passing rate was only 16.5%. (3) infant feeding situation: (1) the feeding mode of infant feeding in 6 months was mainly mixed feeding (60.6%), pure breastfeeding rate reached 34.7%; second, 6 months later added supplementary food 58.6%, 4-5 months of age began to add supplementary food to 21.1%; (3) in this survey, supplementary feeding infants accounted for 90. .8%, 9.2% of infants and young children who had not yet added supplementary food, 47.6% of formula milk powder, 84.9% of the cereals (84.9%), white heart and potato (53.5%), eggs (43.7%), meat and nuts were less; the proportion of infants and young children with nutrient supplements was low, only 8.8%; the proportion of calcium in nutrients was higher, 16.2%, and zinc intake. The ratio is the lowest, only 5.0%. (4) infant detection index: (1) the average hemoglobin value of infant is 11.5 + 1.6g/dl, 59% infant hemoglobin value is lower than normal, and the incidence of infant malnutrition is 21.3%, among which overweight, emaciation, low weight and growth retardation rate are divided into 7%, 4%, 3.2% and 7.1%. (5) infant nutrition status. 1. Single factor chi square test showed: month of age, sex, anemia, preterm birth, birth length and weight, nursing education and occupation, feeding mode, supplementary feeding time, supplementary food addition and nutrient supplement in 6 months were correlated with the occurrence of malnutrition in infants of 6-24 months of age. The results of conditional Logistic regression analysis showed that the factors affecting the nutritional status of 6-24 month old infants were gender, month old, preterm birth, nursing knowledge level, caregiver occupation, supplementary feeding time and supplementary food addition. (1) the rate of growth retardation in 6-24 months old infants in poor areas of Gansu was higher than that of < Chinese children. The requirement for child development program (2011 to 2020) > (below 7%), the prevalence of overweight was higher than the world average (6%), the prevalence of anemia was as high as 59.0%. overweight, anemia was the main nutritional problem for 6-24 months old infants in poor areas in Gansu. (2) the pure breastfeeding rate of 6-24 months old infants in poor areas in Gansu province was lower than that of Chinese children in 6 months. The exhibition program (2011-2020) > requires a level (more than 50%) to make it difficult for infants to get the best breast milk nutrition in 6 months, which is not conducive to the growth and development of children. (3) the supplementary feeding time of 6-24 months old children in the poor areas of Gansu Province, the kind of supplementary food, the quality and frequency of the supplementary food are not reasonable, the addition time of the supplementary food is early, and the addition of the supplementary food is single. The factors such as low quality of supplementary food and irrational feeding frequency are not conducive to the growth and development of infants. (4) the factors affecting infant nutrition in poor areas of Gansu include infant sex, month of age, preterm birth, knowledge level of nursing care, caregiver occupation, supplemental feeding time and supplementary food.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R723.2

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