摘要
[目的]了解上海市闵行区0～3岁婴幼儿生长迟缓的检出率及主要影响因素,为今后的早期干预、营养促进及保健指导提供相关依据.[方法]收集2020年9月1日—2021年8月31日在闵行区各社区卫生服务中心及区妇幼保健院的儿童保健门诊接受过0～3岁系统保健的婴幼儿的身高、体重、父母基本情况、喂养方式及生活习惯等信息,并对引起婴幼儿生长迟缓的现状及影响因素进行分析.[结果]闵行区68 637名进行系统体检的婴幼儿中生长迟缓的总检出率为5.03%(3 453/68 637),其中0～岁组的检出率为6.57%(1 636/24 885),1～岁组的检出率为3.90%(664/17 031),2～岁组的检出率为4.62%(827/17 905),3～岁组的检出率为3.72%(326/8 773).χ2检验结果显示,男女童的生长迟缓检出率差异无统计学意义(P>0.05).将单因素分析中有统计学意义的影响因素(婴幼儿出生体重、出生身长、父母体重、身高、文化程度以及母亲生育年龄、分娩方式、户籍、6月内喂养方式、婴幼儿睡眠情况等)进行多因素logistic回归分析发现,出生体重<2 500 g(OR=3.99,95%CI:2.809～5.674)或≥4 000 g(OR=12.78,95%CI:8.868～18.443)、母亲身高<150 cm(OR=7.10,95%CI:4.294～11.753)、父亲身高<160 cm(OR=5.65,95%CI:2.792～11.422)、母亲初中及以下文化程度(OR=1.31,95%CI:1.087～1.588)、父亲初中及以下文化程度(OR=1.02,95%CI:0.838～1.236)、混合喂养(OR=1.15,95%CI:1.031～1.288)、睡眠大于推荐时间(OR=1.58,95%CI:1.466～1.710)是0～3岁婴幼儿生长迟缓的危险因素.出生身长<50 cm、户籍是上海市的婴幼儿生长迟缓的发生率更高.[结论]0～3岁婴幼儿生长迟缓受遗传、环境、睡眠等综合因素影响,须让家长早期认识到生长迟缓对婴幼儿今后的影响,积极配合参与生长迟缓的早发现、早筛查、早干预.
Abstract
[Objective]To investigate the detection rate and main influencing factors of growth retardation in infants aged 0-3 in Minhang District,and to provide relevant evidence for early intervention,nutrition promotion and health guidance in the future.[Methods]From September 1,2020 to August 31,2021,the height,weight,basic information of parents,feeding methods,and lifestyle habits of infants who received systematic healthcare aged 0-3 in community health service centers and Minhang maternal child health hospital were collected,and the current situation and influencing factors of infant growth retardation were analyzed.[Results]Among the 68 637 infants who underwent a systematic physical examination in Minhang District,the total detection rate of growth retardation was 5.03%(3 453/68 637).The detection rates in the 0-year-old,1-year-old,2-year-old,and 3-year-old groups were 6.57%(1 636/24 885),3.90%(664/17 031),4.62%(827/17 905),and 3.72%(326/8 773),respectively.There was no difference in the detection rate of growth retardation between boys and girls(P>0.05),and a multinomial logistic regression analysis of 13 influencing factors(infant birth weight,birth length,parental weight,height,education level,mother's childbearing age,delivery mode,household registration,feeding mode within 6 months,infant sleep,etc.)in univariate analysis showed that birth weight<2 500 g(OR=3.99,95%CI:2.809-5.674)or≥4 000 g(OR=12.78,95%CI:8.868-18.443),maternal height<150 cm(OR=7.10,95%CI:4.294-11.753),paternal height<160 cm(OR=5.65,95%CI:2.792-11.422),maternal education level of junior high school and below(OR=1.31,95%CI:1.087-1.588),paternal education level of junior high school and below(OR=1.02,95%CI:0.838-1.236),mixed feeding(OR=1.15,95%CI:1.031-1.288),and sleep duration exceeding the recommended time(OR=1.58,95%CI:1.466-1.710)were risk factors for growth retardation in infants aged 0-3.Infants with a birth length<50 cm or with household registration in Shanghai had a higher incidence of growth retardation.[Conclusion]Growth retardation in infants aged 0-3 is influenced by a combination of genetic,environmental,and sleep factors.It is essential for parents to realize the impact of growth retardation on the future of their children early on and actively participate in the early detection,screening,and intervention of growth retardation.
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