Meta-analysis on the effect of breast-feeding in the prevention of respiratory infection

目的 评价母乳喂养对婴儿呼吸道感染的预防保护作用.方法 计算机检索中国生物医学文献光盘数据库、中国期刊全文数据库、维普中文科技期刊、万方数字化期刊等数据库.按纳入、排除标准纳入合格文献进行Meta分析,采用RevMan4.2软件进行.结果 共纳入17篇研究,并对不同月龄大小的婴儿采用分层分析,分别计算其OR值.Meta分析结果表明,新生儿的母乳喂养组与混合喂养组的在新生儿期呼吸道感染情况的合并OR和95％CI为0.71[0.31,1.61];6个月的婴儿母乳喂养组与混合喂养组在6个月内感染的合并OR和95％CI为0.58[0.49,0.70];6个月的婴儿母乳喂养组与人工喂养组的合并OR和95％CI为0.33[0.22,0.49];一周岁的婴儿母乳喂养组与混合喂养组在一年内感染的合并OR和95％CI为0.98[0.38,2.49];一周岁的婴儿母乳喂养组与人工喂养组的合并OR和95％CI为0.40[0.16,1.04].结论 6个月的婴儿母乳喂养组在6个月期间患呼吸道感染情况要明显低于混合喂养组与人工喂养组,支持母乳喂养对呼吸道感染的保护作用,但同时由于纳入研究的数量少、潜在的发表偏倚和质量不高,新生儿及一周岁婴儿的母乳喂养组未体现明显保护作用.因此,对新生儿期及一周岁婴儿继续开展高质量、大样本的调查非常必要.     

3组不同喂养方法对转乳期婴儿体重及身长的影响

目的观测不同喂养方法对生后6个月内婴儿身长、体重的影响。方法我院儿童保健门诊体检的婴儿385例（分为3组：纯母乳喂养组、混合喂养组和人工喂养组）,3组婴儿出生时体重、身长差异均无显著性,（P〉0.05）分别于生后42天、4个月、6个月进行身长、体重的观测。结果生后42天纯母乳喂养组的身长、体重增长值均明显高于混合喂养组及人工喂养组,差异有显著性（P〈0.01）。生后4个月、6个月纯母乳喂养组体重和身长均高于混合喂养组,但差异无显著性（P〉0.05）。生后4个月、6个月母乳喂养组身长与人工喂养组差异无显著性（P〉0.05）,但体重与人工喂养组比较,差异有显著性（P〈0.01）。结论婴儿母乳喂养比混合喂养及人工喂养具有明显的优越性,母乳喂养有利于促进婴儿的体格发育和健康成长。     

不同喂养方式对婴儿体格发育的影响

目的: 探讨不同喂养方式对婴儿体格发育的影响. 方法:选择健康婴儿246例,根据其生后前4个月的喂养方式分为母乳喂养组、混合喂养组和人工喂养组,在生后的42 d、3个月、6个月龄时分别测量其体重和身长及6个月时的血红蛋白含量.结果: 3组婴儿的体重和身长在42 d、3个月时差异无统计学意义(P＞0.05);6个月时各组婴儿身长差异无统计学意义(P＞0.05),母乳喂养组和人工喂养组婴儿体重低于混合喂养组,差异有统计学意义(F=3.72,P＜0.05);混合喂养组婴儿贫血发生率高于母乳和人工喂养组(P<0.05).结论: 母乳喂养的婴儿6个月时体重增长速度减慢,混合喂养和母乳喂养婴儿的生长模式可能存在差异;混合喂养组婴儿6个月时出现贫血,可能与生长过快及铁吸收不良有关.     

母乳喂养与婴儿HCV感染关系的META分析

目的:探讨母乳喂养与婴儿HCV感染的关系.方法:为了获取适于META分析的文献,对中国生物医学数据库、维普数据库、方正数据库、PUBMED数据库和MEDLINE进行检索. 纳入标准依据Abdolmaleky HM方法[1]. 用RevMan4.2软件对纳入文献采用固定效应模型或随机效应模型计算OR值. χ2检验每组OR值异质性. 联系的强度采用OR值进行评价.结果:对中国生物医学数据库和MEDLINE进行检索后共有120篇文献,37篇为综述,被舍弃. 对其余文献进行仔细阅读后,只有6篇文献符合本次研究标准. META分析OR值为0.6 (95%CI=0.22-1.60),证实母乳喂养与婴儿HCV感染无关.结论:母乳喂养不是婴儿感染HCV的危险因素.     

不同喂养方式对婴儿缺铁性贫血的影响

目的了解婴儿缺铁性贫血与不同喂养方式之间的关系,为婴儿科学喂养提供依据。方法选择2010年11月-2011年4月在我院儿童保健门诊体检的273例6个月健康婴儿,测定其末梢血血红蛋白,按喂养方式分为母乳喂养组105人,部分母乳喂养组86人,人工喂养组82人,比较这三组婴儿缺铁性贫血发生率。结果 6个月婴儿缺铁性贫血发生率母乳喂养为12.38%,混合喂养为2.32%,人工喂养1.19%。结论母乳喂养组婴儿较部分母乳喂养组婴儿及人工喂养组婴儿缺铁性贫血发生率高。     

人工喂养与母乳喂养婴儿的免疫功能检测及意义

目的 探讨人工喂养与母乳喂养婴儿的免疫功能,为大力提倡母乳喂养提供理论依据。方法 对本市人工喂养（n=220)和母乳喂养（n=260）两组4－6个月婴儿分别进行免疫功能检测,并调查半年内呼吸道感染发生率。结果 ①人工喂养组血清免疫球蛋白IgG,IgM与母乳喂养组差异无显著性（P＞0．05）,IgA明显降低（P＜0．01）,IgE明显升高（P＜0．01）;人工喂养组静脉血CD^3 与母乳喂养组差异无显著性（P＞0．05）,CD^4 明显下降（P＜0．01）,CD^8 明显升高（P＜0．01）,CD^4 /CD^8 比值明显下降（P＜0．01）。②人工喂养组呼吸道感染发生率较母乳喂养组明显升高（P＜0．01）。结论 人工喂养婴儿免疫功能失调,更易患呼吸道感染。     

母乳喂养与人工喂养对婴儿生长发育影响的研究

目的比较母乳喂养与人工喂养对婴儿生长发育的影响。方法选择足月出生的正常体重儿,分母乳喂养组（124例）和人工喂养组（89例）,随访6个月,比较不同时间点两组体重、身高、常见病患病次数的差异。结果在出生后3个月、6个月两个相同的时点,母乳喂养组婴儿的身高和体重在正常范围内均高于人工喂养组,差异有极显著性意义（P〈0.01）,且出生后6个月内母乳喂养组呼吸道疾病发病率（25.8%）低于人工喂养组（46.1%）,差异有极显著性意义（P〈0.01）。结论母乳喂养是一种天然的喂养方式,对促进婴儿生长发育的作用明显,是目前人工喂养无法取代的喂养方式。     

我国肝衰竭医院感染危险因素的Meta分析

目的系统评价我国肝衰竭医院感染危险因素相关研究,分析医院感染高危因素,为制订医院感染控制策略提供依据。方法检索CNKI、Wanfang、VIP、CBM、Pubmed、ISI、Embase、Cochrane数据库文献,采用NOS标准对纳入文献进行质量评价及Meta分析。结果纳入21篇文献,肝衰竭3977例,合并医院感染2040例。Meta分析结果显示：1肝衰竭医院感染在〈60岁与≥60岁组间差异有统计学意义[OR=0.37,95%CI（0.24,0.57）,P〈0.00001]。2肝衰竭医院感染在急性与亚急性肝衰竭组间[OR=0.52,95%CI（0.31,0.87）,P=0.01];在亚急性与慢性肝衰竭组间[OR=0.56,95%CI（0.38,0.82）,P=0.003];在急性与慢性肝衰竭组间差异有统计学意义[OR=0.31,95%CI（0.19,0.50）,P〈0.0001]。3肝衰竭医院感染在住院时间≤30 d与〉30 d组间[OR=0.25,95%CI（0.17,0.36）,P〈0.000 01];使用与未使用激素组间差异有统计学意义[OR=2.58,95%CI（1.87,3.56）,P〈0.000 01]。结论医院感染为影响肝衰竭患者预后的重要因素,其危险因素复杂多样。年龄超过60岁、住院超过1月、使用激素及慢性肝衰竭为重要危险因素。     

母乳喂养减少婴儿腹泻和呼吸道感染

目的：比较不同喂养方式与婴儿腹泻及呼吸道感染的关系，探讨母乳对婴儿感染性疾病的影响。方法：通过放射免疫方法测定婴儿粪便的ＳＩｇＡ含量，采用随访方式调查婴儿腹泻和呼吸感染的发生率。结果：在出生后１￣４月，母乳喂养儿粪便的ＳＩｇＡ含量明显高于人工喂养儿，而母乳喂养儿腹泻在呼吸感染率在６个月内均显著低于人工喂养儿。结论：母乳能减少婴儿腹泻及呼吸道感染的发生，母乳中的ＳＩｇＡ是保护婴儿免受感染的重要物质。     

宁波市象山县婴儿肥胖检出率及喂养状况调查

目的调查宁波市象山县婴儿肥胖检出率及喂养状况。方法对本地区478名12月龄婴儿进行体格检查和问卷调查,分析肥胖情况和喂养方式。结果肥胖率为9.83%。出生后至12月龄单纯母乳喂养构成比逐渐下降,混合喂养和单纯人工喂养的构成比逐渐上升,9个月后混合喂养构成比下降,人工喂养构成比最高。母乳喂养时间越长婴儿肥胖率越低,而在4～6个月添加辅食的婴儿肥胖率较低。单纯母乳喂养组超重及肥胖检出率均最低。不同母乳喂养持续时间、添加辅食时间的婴儿肥胖率差异有统计学意义(P<0.05),母乳喂养及母乳喂养时间长对婴儿肥胖有保护作用。结论早期添加配方奶粉及辅食喂养导致婴儿早期肥胖可能性增加,母乳喂养及母乳喂养时间长可降低婴儿的肥胖率。     

婴儿缺铁性贫血影响因素的病例对照研究

目的：探讨长沙市8月龄婴儿缺铁性贫血状况及其影响因素。方法：采用病例对照研究,将8月龄规范 化血常规检测明确诊断为缺铁性贫血的105例婴儿纳入病例组,按1:4个体匹配,发生1个新病例的同时选取4例同 一街道、同一性别按相同标准诊断未发生缺铁性贫血的婴儿作入对照组,收集相关资料,运用χ2检验、条件logistic 回归分析婴儿缺铁性贫血发生的影响因素。结果：长沙市8月龄婴儿缺铁性贫血发生率为14.7%。8月龄婴儿发生缺 铁性贫血的危险因素包括：母亲孕晚期贫血(OR=3.540,95% CI：1.898~6.601)、6月龄内混合喂养(OR=1.682,95% CI：1.099~2.574)、6月龄内人工喂养(OR=4.162,95% CI：1.343~12.896)、6月龄前添加辅食(OR=1.423,95% CI： 1.022~1.982)、7月龄及以后添加辅食(OR=4.415,95% CI：2.150~9.064)、 8月龄内反复呼吸道感染(OR=2.878,95% CI：1.224~6.764)、8月龄内反复腹泻(OR=3.710,95% CI：1.533~8.980)。结论：长沙市8月龄婴儿缺铁性贫血仍有一定 的发生率,应改善母亲孕期贫血,提倡科学喂养,鼓励纯母乳喂养至6月龄,并及时合理添加辅食,积极治疗罹患呼 吸系统和消化系统疾病的患儿,预防婴儿缺铁性贫血的发生。     

Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus

CONTEXT: Current evidence that breastfeeding is beneficial for infant and child health is based exclusively on observational studies. Potential sources of bias in such studies have led to doubts about the magnitude of these health benefits in industrialized countries. OBJECTIVE: To assess the effects of breastfeeding promotion on breastfeeding duration and exclusivity and gastrointestinal and respiratory infection and atopic eczema among infants. DESIGN: The Promotion of Breastfeeding Intervention Trial (PROBIT), a cluster-randomized trial conducted June 1996-December 1997 with a 1-year follow-up. SETTING: Thirty-one maternity hospitals and polyclinics in the Republic of Belarus. PARTICIPANTS: A total of 17 046 mother-infant pairs consisting of full-term singleton infants weighing at least 2500 g and their healthy mothers who intended to breastfeed, 16491 (96.7%) of which completed the entire 12 months of follow-up. INTERVENTIONS: Sites were randomly assigned to receive an experimental intervention (n = 16) modeled on the Baby-Friendly Hospital Initiative of the World Health Organization and United Nations Children's Fund, which emphasizes health care worker assistance with initiating and maintaining breastfeeding and lactation and postnatal breastfeeding support, or a control intervention (n = 15) of continuing usual infant feeding practices and policies. MAIN OUTCOME MEASURES: Duration of any breastfeeding, prevalence of predominant and exclusive breastfeeding at 3 and 6 months of life and occurrence of 1 or more episodes of gastrointestinal tract infection, 2 or more episodes of respiratory tract infection, and atopic eczema during the first 12 months of life, compared between the intervention and control groups. RESULTS: Infants from the intervention sites were significantly more likely than control infants to be breastfed to any degree at 12 months (19.7% vs 11.4%; adjusted odds ratio [OR], 0.47; 95% confidence interval [CI], 0.32-0.69), were more likely to be exclusively breastfed at 3 months (43.3% vs 6.4%; P<.001) and at 6 months (7.9% vs 0.6%; P =.01), and had a significant reduction in the risk of 1 or more gastrointestinal tract infections (9.1% vs 13.2%; adjusted OR, 0.60; 95% CI, 0.40-0.91) and of atopic eczema (3.3% vs 6.3%; adjusted OR, 0.54; 95% CI, 0.31-0.95), but no significant reduction in respiratory tract infection (intervention group, 39.2%; control group, 39.4%; adjusted OR, 0.87; 95% CI, 0.59-1.28). CONCLUSIONS: Our experimental intervention increased the duration and degree (exclusivity) of breastfeeding and decreased the risk of gastrointestinal tract infection and atopic eczema in the first year of life. These results provide a solid scientific underpinning for future interventions to promote breastfeeding.     

独活寄生汤联合针灸治疗膝骨关节炎的系统评价与Meta分析*

目的探讨临床中使用独活寄生汤联合针灸治疗膝骨关节炎（KOA）的临床疗效。方法 对临床中常用中、英文7个数据库（中国知网、中国生物医学文献数据库、万方数据库、维普数据库、Clinical trials.gov、PubMed,Cochrane Library）中收录的独活寄生汤联合针灸治疗膝骨关节炎的相关文献进行系统检索,文献发表选取区间为从建库起至2019年3月。将检索出的相关文献按照本次研究所设定的纳入标准及排除标准等进行筛选,得到最终纳入文献。由3名资深研究者对最终纳入文献进行质量评估,其评估标准参照Cochrane Handbook for Systematic Reviews of Interventions,同时运用Review Manager5.3软件对符合标准的文献进行Meta分析。结果 按照检索标准共检索出相关文献158篇,其中中文数据库检索出文献152篇,英文数据库英文文献6篇,按照要求最终纳入文献7篇。与对照组比较,临床疗效Meta分析结果示[OR=3.56,95%CI (2.22,5.71),P<0.000 01];关节疼痛改善情况Meta分析结果示[MD=-1.14,95%CI(-1.83,-0.46),P=0.001];WOMAC评分改善情况Meta分析结果示[MD=-19.26,95%CI (-21.45,-17.07),P<0.000 01];肿胀度改善情况Meta分析结果示[MD=-0.30,95%CI (-0.40, -0.21),P=0.000 01];不良反应发生情况Meta分析结果示[OR=0.09,95%CI (0.03,0.31),P=0.000 1]。结论 独活寄生汤联合针灸治疗膝骨关节炎能够有效的提高临床有效率、缓解疼痛、提高关节功能、减轻关节肿胀度且不良反应较少,临床值得推广。但其临床效果是否优于单一运用独活寄生汤或针灸方面证据不足,需更多的高质量研究来证实其有效性及安全性。     

急性心肌梗死患者院前延迟影响因素的系统评价及防控对策

目的 探讨急性心肌梗死患者院前延迟的影响因素,并明确应对策略,旨在缩短院前延迟时间。 方法 经Pubmed、Embase等十大数据库检索相关文献,用NOS量表评价纳入文献19篇,均为流行病调查研究,以Rev Man 5.3软件进行统计分析。 结果 通过Meta分析将影响因素归纳为3大类。①社会因素:年龄[OR=1.090,95%CI(1.060～1.130),P＜0.001]、性别[OR=1.180,95%CI(1.050～1.330),P=0.006]、文化水平[OR=1.410,95%CI(1.190～1.670),P＜0.001]、居住地区[OR=1.350,95%CI(0.990～1.840),P=0.060];②临床因素:糖尿病史[OR=1.380,95%CI(1.220～1.560),P＜0.001]、心绞痛史[OR=1.370,95%CI=1.050～1.770,P=0.020]、心肌梗死史[OR=1.080,95%CI(0.640～1.830),P=0.760]、PCI史[OR=0.760,95%CI(0.670～0.860),P＜0.001];③其他因素: 夜间发病[OR=1.630,95%CI(1.340～1.970),P＜0.001]、就诊方式[OR=0.640,95%CI(0.570～0.710),P＜0.001]、未将症状归因于心脏[OR=3.100,95%CI(1.620～5.940),P＜0.001]。 结论 高龄、女性、糖尿病史、心绞痛史、夜间发病、未将症状归因于心脏是其危险因素,高学历、PCI史、EMS就诊是其保护因素,居住地区、心肌梗死史与急性心肌梗死患者院前延迟无关。采取切实有效地干预措施,能够缩短院前延迟时间,降低患者院外死亡率。      

Socioeconomic status and rates of breastfeeding in Australia: evidence from three recent national health surveys

OBJECTIVE: To investigate whether the relationship between socioeconomic status and breastfeeding initiation and duration changed in Australia between 1995 and 2004. DESIGN AND SETTING: Secondary analysis of data from national health surveys (NHSs) conducted by the Australian Bureau of Statistics in 1995, 2001 and 2004-05. The Socio-Economic Indexes for Areas (SEIFA) classification was used as a measure of socioeconomic status. MAIN OUTCOME MEASURES: Rates of initiation of breastfeeding; rates of breastfeeding at 3, 6 and 12 months. RESULTS: Between the 1995 and 2004-05 NHSs, there was little change in overall rates of breastfeeding initiation and duration. In 2004-05, breastfeeding initiation was 87.8%, and the proportions of infants breastfeeding at 3, 6 and 12 months were 64.4%, 50.4% and 23.3%, respectively. In 1995, the odds ratio (OR) of breastfeeding at 6 months increased by an average of 13% (OR, 1.13 [95% CI, 1.07-1.19]) for each increase in SEIFA quintile; in 2001, the comparative increase was 21% (OR, 1.21 [95% CI, 1.12-1.30]); while in 2004-05, the comparative increase was 26% (OR, 1.26 [95% CI, 1.17-1.36]). Breastfeeding at 3 months and 1 year showed similar changes in ORs. There was little change in the ORs for breastfeeding initiation. CONCLUSION: Although overall duration of breastfeeding remained fairly constant in Australia between 1995 and 2004-05, the gap between the most disadvantaged and least disadvantaged families has widened considerably over this period.     

HBV携带产妇的血清及乳汁HBV-DNA载量的差异与母乳喂养安全性的研究

目的 探讨HBV携带产妇的血清、乳汁中HBV-DNA不同裁量与实施母乳喂养安全性的关系及对母婴传播阻断效果的影响.方法 应用荧光定量聚合酶链反应和酶免疫测定(EIA)技术对91例HBsAg、HBeAg双阳性产妇血清、乳汁及婴儿24月龄血标本进行HBV-DNA定量和HBVM检测.32例婴儿采用母乳喂养,59例采用人工喂养.对两种喂养方式的婴儿做3(T3)、9(T9)、12(T12)、24(T24)个月追踪检测观察.结果 HBsAg、HBeAg双阳性产妇的血清、乳汁中HBV-DNA阳性率为100%、49.45%(P＜0.005),HBV-DNA平均含量(拷贝数/毫升的对数,(-x)±s)为(7.43±1.81)、(4.02±1.01);初乳HBV-DNA的检出率随母血HBV-DNA载量的增加而增加,两者呈正相关.母乳和人工两种方式喂养的婴儿HBV感染率为15.63%和13.56%,统计学处理X2=0.022,P＞0.05差异无显著性;母乳喂养组抗体几何平均滴度(GMT)明显高于人工喂养组;发生HBV-DNA感染的13例婴儿T24血标本HBV-DNA载量为(3.24±0.23).结论 HBsAg、HBeAg双阳性产妇血清HBV-DNA载量大于109cps/mL的婴儿是母婴传播的高危易感人群.HBV感染的婴儿HBV-DNA水平较低,病毒载量＜104cps/mL.乳汁HBV-DNA阳性率和病毒载量明显低于血清,HBV携带产妇的婴儿接受正规乙肝基因工程疫苗(Hbice)全程免疫或Hbice和HBIG(乙肝免疫球蛋白)的主、被动联合免疫后,母乳喂养不影响母婴传播阻断效果,母乳喂养有助于提高婴儿抗-HBs的GMT水平.     

Prevalence of anemia among James Bay Cree infants of northern Quebec

BACKGROUND: Anemia is common among First Nation infants in Canada, often as a result of iron deficiency, which places them at risk for psychomotor impairment. Prevalence data are unavailable, and the risk factors are unknown. This study assessed the prevalence of anemia and associated risk factors among 9-month-old Cree infants in northern Quebec. METHODS: Between January 1995 and October 1998, 6 of 9 Cree villages in the James Bay region adopted a screening protocol for anemia in 9-month-old infants. Cross-sectional data were obtained from medical charts. The data for babies of very low birth weight and those with fever or infection were excluded. Among the 386 babies whose hemoglobin concentration was known, the type of milk consumed at the time of screening was known for 354. Associations between hemoglobin concentration and mean cell volume at 9 months, and milk type and weight gain since birth were analysed. RESULTS: The mean hemoglobin concentration of the 386 infants was 114.1 (standard deviation [SD] 10.6) g/L. The prevalence of anemia was 31.9% (95% confidence interval [CI] 27.2%-36.7%) with a hemoglobin cutoff value of 110 g/L, 17.6% 95% CI 13.9%-21.7%) with a cutoff value of 105 g/L, and 7.8% (95% CI 5.3%-10.9%) with a cutoff value of 100 g/L. Babies exclusively fed formula at 9 months had a higher mean hemoglobin concentration (118.5 [SD 9.9] g/L) than those exclusively fed breast milk (109.9 [SD 10.0] g/L), cow's milk (112.5 [SD 10.1] g/L) or more than one type of milk (112.0 [SD 10.8] g/L) (p < 0.05). Compared with formula, the odds ratio (OR) for anemia was 7.9 (95% CI 3.4-18.2) for breast milk, 5.0 (95% CI 2.0-12.7) for cow's milk and 5.2 (95% CI 1.9-14.6) for mixed milks. Infants fed formula and those fed cow's milk had significantly greater weight gains since birth, by 724 g and 624 g respectively, than breast-fed infants (p < 0.05). When milk type was controlled for, weight gain since birth was significantly associated with the presence of microcytic erythrocytes (OR comparing highest tertile of weight gain to lowest tertile 2.9, 95% CI 1.2-6.6). INTERPRETATION: Iron-deficiency anemia is highly prevalent among James Bay Cree infants. Measures to increase iron intake are required.     

Iron deficiency anemia in 1-year-old children of disadvantaged families in Montreal.

OBJECTIVES: To determine the prevalence of iron deficiency anemia among 1-year-old infants of disadvantaged families in Montreal as well as certain predictors of this condition. DESIGN: Cohort study. SETTING: Five poorest health districts in Montreal. PARTICIPANTS: Infants 10 to 14 months of age were identified from registration lists of births from May 1988 to August 1989. Those whose mother had less than 11 years of schooling and a family income below the government-defined low-income cutoff point were eligible. INTERVENTION: During a home visit capillary blood samples were obtained from the child, and the mother answered a questionnaire about infant-feeding practices. Infants with a serum ferritin level of 10 micrograms/L or less and either a hemoglobin level of 115 g/L or less or a mean corpuscular volume of 72 fL or less were considered as having iron deficiency anemia. RESULTS: Of the 299 mothers who were eligible and could be located 220 (74%) agreed to participate; 218 blood samples were available. Iron deficiency anemia was found in 25% of the infants (95% confidence interval [CI] 19% to 31%). The mean hemoglobin level was 115 (standard deviation 11) g/L. The serum ferritin level, assessed routinely in the last 62 infants, was 10 micrograms/L or less in 37% of the infants. The factors that were found to be predictors of iron deficiency anemia included the use of whole cow's milk before 6 months of age (odds ratio [OR] 3.56 [95% CI 1.07 to 11.26]) and the use of iron-fortified infant cereal for less than 6 months (OR 3.15 [95% CI 1.25 to 7.96]). A low birth weight and the use of iron-fortified formula for less than 6 months were associated with iron deficiency anemia. CONCLUSIONS: Despite a decrease in the prevalence of iron deficiency anemia among children of disadvantaged families in the United States socioeconomically disadvantaged infants in Montreal are at risk. Preventive measures must be taken to ensure adequate iron status in the first year of life.     

贫困农村地区6~23月龄婴幼儿发热和腹泻2周患病率的影响因素

目的：了解贫困农村地区6~23月龄婴幼儿发热和腹泻2周患病现状及其影响因素。方法：2015年8月在 湖南省辖区内武陵山区和罗霄山区30个贫困县采用乡级概率规模抽样方法,随机抽取8 735名农村6~23月龄婴幼儿 作为研究对象,采用问卷调查婴幼儿过去2周发热和腹泻患病情况、个人及出生基本情况、家庭及喂养情况,计 算婴幼儿发热和腹泻2周患病率,采用多因素非条件logistic回归模型分析婴幼儿发热和腹泻2周患病的影响因素。 结果：6~23月龄婴幼儿的发热和腹泻2周患病率分别为20.8%和12.2%。多因素非条件logistic回归分析结果显示：18~23 月龄(OR=0.66,95% CI：0.58~0.75)、侗族(OR=1.42,95% CI：1.17~1.74)和低体重(OR=1.31,95% CI：1.11~1.54)是贫 困农村地区6~23月龄婴幼儿发热2周患病的影响因素;性别为女(OR=0.86,95% CI：0.76~0.98)、12~17月龄(OR=0.80, 95% CI：0.69~0.93)、18~23月龄(OR=0.51,95% CI：0.43~0.60)、其他少数民族(OR=1.70,95% CI：1.13~2.56)、未添加 辅食(OR=1.65,95% CI：1.05~2.59)和低体重(OR=1.39,95% CI：1.14~1.70)是贫困农村地区6~23月龄婴幼儿腹泻2周患 病的影响因素。结论：贫困农村地区6~23月龄婴幼儿发热和腹泻2周患病率仍处于较高水平,低月龄、侗族、低体重 是贫困农村地区婴幼儿发热2周患病的危险因素,男性、低月龄、未添加辅食、低体重是贫困农村地区婴幼儿腹泻2 周患病的危险因素。