浙江省某市2002-2015年婴幼儿营养状况分析

目的 了解浙江省某市2002-2015年婴幼儿营养状况，分析有关影响因素。方法 利用该市电子医疗记录数据库，提取孕妇首次随访数据与婴幼儿体格检查数据。采用Z值评分对婴幼儿营养状况进行评价，应用Logistic回归探讨婴幼儿生长不良的影响因素。结果 在48 827名体检的婴幼儿中，低体重、生长迟缓、消瘦、超重、肥胖率分别为1.43%、1.31%、1.90%、2.62%、0.34%。不同性别间肥胖发生率的差别具有统计学意义（χ2=5.164，P=0.023）。婴幼儿超重、肥胖检出率呈逐年下降趋势，低体重率呈上升趋势。Logistic回归分析显示，母亲高文化程度是婴幼儿低体重、生长迟缓、消瘦的保护因素；孕前体重指数（body mass index，BMI）较高是婴幼儿超重（OR=1.063，95%CI:1.057~1.069，P<0.001）、肥胖（OR=1.074，95%CI:1.060~1.088，P<0.001）的危险因素；高危妊娠是婴幼儿低体重（OR=2.214，95%CI:1.928~2.542，P<0.001）、生长迟缓（OR=2.543，95%CI:2.193~2.949，P<0.001）、消瘦（OR=1.211，95%CI:1.062~1.380，P=0.004）的危险因素。结论 该地区婴幼儿生长发育情况总体良好，但仍面临营养不良与营养过剩的双重问题。母亲孕前BMI、文化程度及是否高危妊娠是儿童生长不良的影响因素。

Nutrition status of infants in a city of Zhejiang Province from 2002 to 2015

Objective To explore the nutritional status of young children in a city in Zhejiang from 2002 to 2015 and analyze potential influencing factors. Methods We used electronic medical recorder system and extracted maternal and offspring's medical information from the decoded database. Z-scores were used to elevate nutrition status. Logistic regression models were used to explore the influencing factors of the nutritional status. Results Among 48 827 children, the prevalence rate of underweight, stunting, thinness, overweight and obesity were 1.43%, 1.31%, 1.90%, 2.62%, and 0.34%, respectively. The prevalence of obesity had significant differences between genders(χ2=5.164,P=0.023). The prevalence of underweight was increased, and the prevalence of overweight and obesity were decreased. Furthermore, mother with higher educational level had lower risk of child's malnutrition, and mother with higher pre-pregnancy body mass index (BMI) had higher risk of child's overweight(OR=1.063, 95% CI:1.057-1.069,P<0.001) and obesity(OR=1.074, 95% CI:1.060-1.088,P<0.001); Maternal high-risk pregnancy was the risk factor of underweight (OR=2.214, 95% CI:1.928-2.542,P<0.001), stunting (OR=2.543, 95% CI:2.193-2.949,P<0.001) and thinness (OR=1.211, 95% CI:1.062-1.380,P=0.004) in children. Conclusions Overall, children's physical development in this city was in good condition. However, problems are still existing with malnutrition and overnutrition. Maternal high pre-pregnancy BMI, low educational level and high-risk pregnancy were independently related to child's malnutrition and overnutrition.