家庭社会经济状况与3岁以内儿童生长发育及营养状况的关系

目的 探究家庭社会经济状况(SES)与3岁以内儿童生长发育及营养状况的关系,为我国儿童预防保健提供科学依据。方法 数据源于2015年中国九市7岁以下儿童体格发育调查的西安地区数据。研究共纳入父/母亲文化程度、父/母亲职业和家庭年收入5项指标因子,构建了SES综合指标作为自变量。结局变量为身长、体重和评估的营养状况结局。调整儿童性别和月龄后,分别建立线性回归和Logistic回归模型,分析SES与身长体重和营养结局的关系。结果 研究共纳入3岁以内儿童12 017人,经评估营养不良者281人(2.3%),营养过剩者531人(4.4%)。调整儿童性别和月龄后,与低水平SES儿童相比,中等水平SES儿童身长增加0.32 cm(95%CI:0.16~0.47),发生营养过剩的风险降低20%(OR =0.80, 95%CI:0.65~0.98);高水平儿童身长增加0.77 cm(95%CI:0.61~0.92),体重增加0.06 kg(95%CI:0.006~0.12),发生营养过剩的风险降低33%(OR=0.67, 95%CI:0.53~0.83)。结论 较好的社会经济状况可能降低营养过剩的风险,有助于儿童的发育与营养健康。应改善家庭育儿环境,加强对低SES家庭的儿保宣教,提高儿童的健康水平。

Association of family socioeconomic status with growth,development and nutritional status of children under 3 years old

Objective To explore the association of family socioeconomic status (SES) with growth, development and nutritional status of children under 3 years old, so as to provide scientific basis for the prevention and health care of children in China. Methods Data were from the database of Xi'an based on the physical development survey of children under 7 years old in nine cities of China in 2015. Socioeconomic status comprehensive indicators included parents'education level, parents'occupation and annual family income. The outcome variables included physical measurement (length and weight) and nutritional status.After adjusting children's gender and month agelinear regression models and Logistic regression models were established to analyze the association between SES and children growth and nutritional outcomes. Results A total of 12 017 children under 3 years old were included in this study, among which 281 (2.3%) children were assessed with malnutrition and 531 (4.4%) children were assessed with overnutrition. After adjusting children's gender and month age, compared with children with low levels of SES, children with moderate levels of SES increased in length by 0.32 cm (95% CI: 0.16 - 0.47) and had a 20% lower risk of overnutrition (OR=0.80, 95%CI: 0.65 - 0.98). Children with high levels of SES increased in length by 0.77 cm (95%CI: 0.61 - 0.92) and weight by 0.06 kg (95% CI: 0.006 - 0.12) and a 33% reduction in the risk of overnutrition (OR=0.67, 95% CI: 0.53 - 0.83). Conclusions Better SES may reduce the risk of overnutrition in children, and contribute to children's physical development and nutritional health. Efforts should be made to improve the family parenting environment, as well as to strengthen the propaganda and education of children's health care in low SES families, thus improving the health level of children.