【作者】 张燕；

【导师】 杜玉开；

【作者基本信息】 华中科技大学 ， 公共卫生， 2017， 硕士

【摘要】 目的:研究武汉市黄陂区0～5岁儿童营养状况及其影响因素,为儿童健康干预提供科学依据。方法:2016年4月在武汉市黄陂区采取多阶段分层整群抽样的方法,抽取10个街道(乡、场、开发区)的2338名0～5岁儿童。采用问卷调查、体格测量、血红蛋白检测进行资料搜集。应用SPSS 21.0软件对数据进行整理和统计学分析,主要运用的统计学方法包括描述性分析、χ~2分析、多因素Logistic回归分析。结果:(1)描述性分析:(1)2338名0～5岁儿童的低体重、生长迟缓的发生率分别为5.6%、1.7%。(2)本研究调查了2338名看护人,其中父母70.8%,初中及以下文化66.9%。家庭年收入中位数为6.0万元。在1495名母亲回答问卷中,1462名母亲建立有孕前保健手册,建册率为97.8%(1462/1495),孕期做过产前检查的占96.8%(1447/1495),产检次数不少于5次的占53.2%(755/1418),住院分娩率为99.6%(2295/2304)。(3)巨大儿出生率为7.5%(171/2289),低体重出生率为3.9%(90/2289)。小于6月龄儿童纯母乳喂养率为44.3%(1036/2338),73.2%(1588/2168)的儿童满6月龄后开始添加辅食。最近两周内有过腹泻的儿童有212人,患有呼吸系统疾病的儿童有717人。贫血检出率为6.9%(160/2323)。(2)单因素分析:月龄,产检,出生体重,孩子每天与母亲相处时间,两周内是否腹泻,家庭年收入的差异对0～5岁儿童低体重的发生有影响;建立孕期保健手册,产检,出生体重、贫血的差异对0～5岁儿童生长迟缓的发生有影响。(3)Logistic回归分析:儿童低体重的影响因素为出生体重、孩子每天与母亲相处的时间、最近两周内腹泻和家庭年收入,最近两周内腹泻儿童发生低体重的风险高于未腹泻儿童(OR=1.89,95%CI=1.10～3.24),出生体重>4.0kg、孩子每天与母亲相处时间≧5小时、家庭年收入>8.0万元是儿童发生低体重的保护因素。儿童生长迟缓的影响因素为出生体重,出生体重<2.5kg儿童生长迟缓的发生风险高于正常出生体重儿童(OR=3.53,95%CI=1.33～9.37)。结论:武汉市黄陂区0～5岁儿童仍存在一定程度的营养不良情况,以低体重为主,生长迟缓情况次之。出生体重为影响儿童发生低体重及生长迟缓的因素,出生体重>4.0kg儿童发生低体重的风险降低,出生体重<2.5kg儿童发生生长迟缓的风险增加。孩子每天与母亲相处时间、最近两周内腹泻、家庭年收入亦对其营养状况有影响。儿童看护人的看护水平有待提高,建议开展多种形式的健康教育,提高看护人养育水平和儿童营养水平。更多还原

【Abstract】 Objects: Exploring nutritional status and influence factors of 0～5 year-old children living in the Huangpi district,Wuhan city.And provide the scientific basis for children’s health intervention.Methods: In April 2016,a multi-stage stratified cluster sampling survey on 2338 children aged 0～5 years old was taken in 10 streets(township,site,development zone)in Huangpi district,Wuhan city.Data were collected by questionnarie,anthropometric measurement and detection of hemoglobin.Descriptive analysis,Chi-square test and multiple logistic regression analysis were conducted in data analysis with SPSS 21.0.Results:(1)Descriptive analysis:(1)The incidence of underweight,stunting were respectively 5.6%,1.7% in 2338 children aged 0～5 years old.(2)2338 caregivers were surveyed totally,the proportion of parents was 70.8%,the education level of junior middle school and below was 66.9%.The median household annual income was 60 thousand yuan.1495 mothers answered the questionnaire,and1462 mothers built preconception care booklets,the rate of building the booklets was97.8%(1462/1495),the rate of making prenatal examination in pregnancy was96.8%(1447/1495),the number of antenatal examination not less than 5 times was53.2%(755/1418),the hospital delivery rate was 99.6%(2295/2304).(3)The birth rate of macrosomia was 7.5%(171/2289),and the rate of low birthweight was 3.9%(90/2289).The pure breastfeeding rate of children under 6months of age was 44.3%(1036/2338),73.2%(1588/2168)of the children started to add complementary food.full after 6 months of age.During the last two weeks,212 children had diarrhea and 717 children had respiratory diseases.The detection rate of anemia was 6.9%(160/2323).(2)Single factor analysis showed that: Difference of children’s monthage,prenatal examination,birthweight,the time children spent with mothers everyday,diarrhea in the last two weeks and household annual income influenced the occurrence of underweight;Difference of buliding the pregnancy care booklets,prenatal examination,children’s birthweight,and anemia influenced the occurrence of stunting.(3)Multiple logistic regression analysis showed that:Birthweight,the time children spent with mothers everyday,diarrhea in the last two weeks and household annual income were influence factors of underweight for children.The risk of underweight in children had diarrhea in the last two weeks was higher than children did not have diarrhea in the last two weeks(OR=1.89,95%CI=1.10～3.24),birthweight > 4.0kg,the time children spent with mothers everyday ≧5h and household annual income >80thousand yuan were protective factors of underweight for children;Low birthweight was risk factor of stunting for children.And the impacted factors of stunting was birthweight,the risk of stunting in children birth weight < 2.5kg was higher than children with normal birtweight(OR=3.53,95%CI=1.33～9.37).Conclusions: There was still a certain degree of malnutrition in children aged 0～5years old in Huangpi district of Wuhan city,underweight was major,the status of stunting was better.Birthweight was affecting factors of underweight and stunting,the risk of underweight in children birthweight >4.0kg reduced,and the risk of stunting in children birthweight < 2.5 kg increased.The time children spent with mothers everyday,diarrhea in the last two weeks,and household annual income were also influenced children’s nutritional status.The nursing level of caregivers needed to be improved,and health education in various forms should be implemented to increase the raising level of caregivers and the nutrition level of children.更多还原