中国21县(市)3～6岁儿童贫血与体格发育的关系研究

目的探讨学龄前儿童贫血与体格发育之间的关系。方法数据来源于北京大学生育健康研究所2000年对河北、江苏和浙江3省21个县市3～6岁儿童所作的随访研究和相关围产保健监测资料。按儿童血红蛋白水平分为正常组、轻度贫血组、中重度贫血组,分别比较各组的身高、体重、BMI、年龄别身高Z评分、年龄别体重Z评分,以及生长迟缓率和体重低下率。结果各年龄段贫血儿童的身高、体重均值显著低于正常组。3～、4～、5～、6～7岁各年龄组轻度贫血男童比正常男童平均身高分别小0.65、0.69、0.94、1.42cm,平均体重分别少0.22、0.18、0.38、0.63kg;而各年龄组轻度贫血女童比正常女童平均身高分别低0.93、0.74、0.88、1.71cm,平均体重分别少0.29、0.22、0.35、0.78kg,以上差异均有显著性(P<0.05)。调整儿童出生体重、城乡地区、母亲身高、母亲初次孕检BMI、母亲文化程度、母亲职业后,轻度贫血儿童发生生长迟缓的危险是非贫血儿童的1.37倍(OR=1.37),而发生体重低下的危险是非贫血儿童的1.32倍(OR=1.32)。结论儿童贫血与体格发育密切相关,应在促进儿童生长发育的同时防治儿童贫血。

The relationship between anemia and physical development among children at the ages of 3-6 years in 21 counties of China

Objective To explore the relationship between anemia and childhood growth among preschool children. Methods The data were from the records of Children Follow-up Study Project carried out by Institute of Reproductive and Child Heath of Peking University and the records of related perinatal health care surveillance system in 21 counties/cities of Hebei, Jiangsu and Zhejiang provinces. These children were divided into three groups based on the hemoglobin concentration-non-anemia group, mild anemia group and middle & grave anemia group. The body height, body weight, BMI, HAZ, WAZ, stunting rate and underweight rate of each group were compared. Results The body height and body weight of each anemia group were significantly lower than those of non-anemia group. For each group of the anemic boys at the ages of 3-,4-,5-,6-7 years, their body heights were averagely shorter by 0.65, 0.69, 0.94 and 1.42cm and their body weights were averagely lighter by 0.22kg, 0.18kg, 0.38kg, 0.63kg than those of non-anemic boys respectively. As for anemic girls at the ages of 3-, 4-,5-, 6-7 years, the body height gaps were 0.93, 0.74, 0.88 and 1.71cm and body weight gaps were 0.29, 0.22, 0.35 and 0.78kg respectively. The anemic children were at higher risk for stunting ( OR = 1.37) and underweight ( OR = 1.32) after adjusting for birth weight, urban & country district, maternal height, maternal BMI at the first prenatal visit, maternal education and occupation. Conclusion There was a significant correlation of growth retardation with childhood anemia, and more efforts should be made to prevent and treat childhood anemia in order to promote children growth.