新疆农牧区哈萨克族学龄前儿童家长喂养行为与儿童贫血的关联

张馨; 杨晶; 阿依努尔

doi:10.16835/j.cnki.1000-9817.2022.03.009

新疆农牧区哈萨克族学龄前儿童家长喂养行为与儿童贫血的关联

doi: 10.16835/j.cnki.1000-9817.2022.03.009

1.
新疆医科大学公共体育教研部, 乌鲁木齐 830000
2.
新疆教育学院体育学院
3.
伊犁哈萨克自治州妇幼保健院儿保科

详细信息

作者简介:
张馨(1976-), 女, 四川德阳人, 硕士, 副教授, 主要研究方向为学生体质健康

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G78 R179 G446
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出版历程
- 收稿日期: 2021-08-26
- 修回日期: 2021-12-21
- 网络出版日期: 2022-03-29
- 刊出日期: 2022-03-25

Association between parental feeding behavior and child anemia of Kazak preschool children in agricultural and pastoral areas of Xinjiang

1.
Department of Public Physical Education, Xinjiang Medical University, Urumqi (830000), China

摘要

摘要: 目的了解新疆农牧区哈萨克族学龄前儿童家长喂养行为和认知状况, 为预防该地区学龄前儿童贫血提供参考。方法 2019年5月采用分层整群抽样方法在新疆农牧区共抽取1 846名哈萨克族学龄前儿童, 对其贫血状况进行检测, 对其家长进行喂养行为调查。结果新疆农牧区哈萨克族学龄前儿童贫血检出率为49.19%, 其中轻度、中重度贫血检出率分别为29.52%, 19.66%。学龄前儿童贫血检出率在不同年龄、父亲学历、母亲学历、家庭人均月收入方面相比较, 差异均有统计学意义(χ²值分别为162.06, 8.17, 16.86, 11.14, P值均＜0.05);在不同辅食种类、营养性贫血、母乳喂养时间、是否强迫进食方面比较, 差异均有统计学意义(χ²值分别为6.33, 8.91, 4.06, 21.55, P值均＜0.05)。Logistic回归分析显示, 不清楚辅食种类(OR=1.36, 95%CI=1.09~1.68)、不清楚营养性贫血(OR=1.38, 95%CI=1.08~1.77)、喂养时间不满24个月或不清楚(OR=1.46, 95%CI=1.01~2.11)、强迫进食(OR=1.42, 95%CI=1.13~1.78)与学龄前儿童贫血的检出率呈正相关(P值均＜0.05)。结论新疆农牧区哈萨克族学龄前儿童贫血状况严重。家长喂养行为与儿童贫血之间存在关联, 是今后改善学龄前儿童贫血的重要方面和途径。
- 行为 /
- 饮食习惯 /
- 贫血 /
- 回归分析 /
- 儿童, 学龄前 /
- 法定监护人 /
- 少数民族
Abstract: Objective To understand parental feeding behavior and cognitive development among Kazak preschool children in agricultural and pastoral areas in Xinjiang, and to provide reference for anemia prevention in preschool children in this area. Methods In May 2019, a total of 1 846 Kazak preschool children were selected from the agricultural and pastoral areas of Xinjiang by stratified cluster sampling method, and parental feeding behavior and child anemia status were assessed. Results The detection rate of anemia in Kazak preschool children in agricultural and pastoral areas in Xinjiang was 49.19%, and the detection rates of mild and moderate anemia were 29.52% and 19.66%, respectively. There were statistically significant differences in the detection rate of anemia in preschool children in terms of age, father's education, mother's education, and family per capita income (χ²=162.06, 8.17, 16.86, 11.14, P < 0.05); There were statistically significant differences in the types of complementary food, nutritional anemia, breastfeeding time, and whether or not to force feeding (χ²=6.33, 8.91, 4.06, 21.55, P < 0.05). Logistic regression analysis showed that parents unclear about the type of complementary food (OR=1.36, 95%CI=1.09-1.68), nutritional anemia (OR=1.38, 95%CI=1.08-1.77), feeding time less than 24 months or unawareness (OR=1.46, 95%CI=1.01-2.11) and forced feeding (OR=1.42, 95%CI=1.13-1.78) were positively correlated with the detection rate of anemia in preschool children (P < 0.05). Conclusion Kazak preschool children in agricultural and pastoral areas in Xinjiang have severe anemia. There is a relationship between parental feeding behavior and children's anemia, which warrants further efforts to improve preschool children's anemia.
- Behavior /
- Food habits /
- Anemia /
- Regerssion analysis /
- Child, preschool /
- Legal guardians /
- Minority groups
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表 1 不同人口学特征新疆农牧区哈萨克族学龄前儿童贫血检出率比较

Table 1. Comparison of the detection rate of anemia among Kazak preschool children in Xinjiang farming and pastoral areas with different demographic characteristics

人口学指标	组别	人数	轻度贫血			中重度贫血			合计
人口学指标	组别	人数	检出人数	χ²值	P值	检出人数	χ²值	P值	检出人数	χ²值	P值
性别	男	1 010	300(29.70)	0.03	0.86	200(19.80)	0.03	0.86	500(49.50)	0.09	0.76
	女	836	245(29.31)			163(19.50)			408(48.80)
月龄/月	0~12	280	116(41.43)	69.54	＜0.01	78(27.86)	41.50	＜0.01	194(69.29)	162.06	＜0.01
	13~36	449	179(39.87)			119(26.50)			298(66.37)
	≥37	1 117	250(22.38)			166(14.86)			416(37.24)
父亲学历	初中及以下	732	234(31.97)	3.49	0.17	156(21.31)	2.11	0.35	390(53.28)	8.17	＜0.05
	高中	463	130(28.08)			87(18.79)			217(46.87)
	大专及以上	651	181(27.80)			120(18.43)			301(46.24)
母亲学历	初中及以下	694	230(33.14)	7.06	＜0.05	154(22.19)	4.49	0.11	384(55.33)	16.86	＜0.01
	高中	508	137(26.97)			92(18.11)			229(45.08)
	大专及以上	644	178(27.64)			117(18.17)			295(45.81)
家庭人均月收入/元	＜2 000	275	95(34.55)	4.51	0.10	64(23.27)	3.10	0.21	159(57.82)	11.14	＜0.01
	2 000~4 999	845	249(29.47)			166(19.64)			415(49.11)
	≥5 000	726	201(27.69)			133(18.32)			334(46.01)
注： ()内数字为检出率/%。

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表 2 新疆农牧区家长不同喂养认知与行为哈萨克族学龄前儿童贫血检出率比较

Table 2. Comparison of the detection rate of anemia in Kazak preschool children with different feeding cognition and behaviors of parents in farming and pastoral areas of Xinjiang

喂养认知及行为	选项	人数	轻度贫血			中重度贫血			总计
喂养认知及行为	选项	人数	检出人数	χ²值	P值	检出人数	χ²值	P值	检出人数	χ²值	P值
添加辅食时间	满6个月	425	123(28.94)	0.09	0.76	82(19.29)	0.05	0.82	205(48.24)	0.20	0.65
	其他	1 421	422(29.70)			281(19.77)			703(49.47)
辅食种类	铁米粉	990	276(27.88)	2.77	0.10	184(18.59)	1.57	0.21	460(46.46)	6.33	＜0.05
	不清楚	856	269(31.43)			179(20.91)			448(52.34)
补铁食物	红肉	215	64(29.77)	0.01	0.92	42(19.53)	0.00	1.00	106(49.30)	0.01	0.92
	不清楚	1 631	481(29.49)			321(19.68)			802(49.17)
营养性贫血	铁	581	154(26.51)	3.71	0.05	102(17.56)	2.39	0.12	256(44.06)	8.91	＜0.01
	不清楚	1 265	391(30.91)			261(20.63)			652(51.54)
母乳喂养时间	满24个月	185	47(25.41)	1.68	0.19	31(16.76)	1.10	0.29	78(42.16)	4.06	＜0.05
	不满24个月或不清楚	1 661	498(29.98)			332(19.99)			830(49.97)
吃饭时转移注意力	是	816	223(27.33)	0.06	0.81	148(18.14)	0.04	0.84	371(45.47)	0.15	0.70
	否	771	215(27.89)			143(18.55)			358(46.43)
是否强迫进食	是	572	184(32.17)	9.61	＜0.01	123(21.50)	5.74	＜0.05	307(53.67)	21.55	＜0.01
	否	1 015	253(24.93)			169(16.65)			422(41.58)
是否经常提供零食	是	559	146(26.12)	0.87	0.35	98(17.53)	0.43	0.51	244(43.65)	1.82	0.18
	否	1 028	291(28.31)			194(18.87)			485(47.18)
夜里喂奶	是	451	127(28.16)	0.10	0.75	84(18.63)	0.04	0.84	211(46.78)	0.18	0.62
	否	1 136	311(27.38)			207(18.22)			518(45.60)
注：喂养行为只针对≥12个月儿童的家长进行调查；()内数字为检出率/%。

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表 3 新疆农牧区哈萨克族学龄前儿童家长喂养认知与行为对儿童贫血状况影响的Logistic回归分析(n=1 846)

Table 3. Logistic regression analysis of parental feeding cognition and behavior of Kazak preschool children in agricultural and pastoral areas of Xinjiang on children's anemia status(n=1 846)

喂养认知及行为	选项	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
辅食种类	铁米粉					1.00
	不清楚	0.32	0.12	8.21	＜0.01	1.36(1.09~1.68)
营养性贫血	铁					1.00
	不清楚	0.34	0.13	7.31	0.01	1.38(1.08~1.77)
母乳喂养时间	满24个月					1.00
	不满24个月或不清楚	0.41	0.18	4.21	0.04	1.46(1.01~2.11)
是否强迫进食	否					1.00
	是	0.37	0.12	9.77	＜0.01	1.42(1.13~1.78)
注：喂养行为只针对≥12个月儿童的家长进行调查。

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参考文献(20)

[1]	LI H, XIAO J, LIAO M, et al. Anemia prevalence, severity and associated factors among children aged 6-71 months in rural Hunan Province, China: a community-based cross-sectional study[J]. BMC Public Health, 2020, 20(1): 989. doi: 10.1186/s12889-020-09129-y
[2]	PASQUALINO M M, THORNE-LYMAN A L, SWETHA M, et al. The risk factors for child anemia are consistent across 3 National Surveys in Nepal[J]. Curr Dev Nutr, 2021, 31(6): 6.
[3]	MEGALLY R, GHONEIM H. Evaluation of health intervention: a case of preschool children in Egypt[J]. Palgr Commun, 2020, 6(1): 83. doi: 10.1057/s41599-020-0450-3
[4]	《中华儿科杂志》编辑委员会. 儿童缺铁和缺铁性贫血防治建议[J]. 中国儿童保健杂志, 2010, 18(8): 724-726. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201008040.htm "Chinese Journal of Pediatrics" Editorial Committee. Recommendations for the prevention and treatment of iron deficiency and iron deficiency anemia in children[J]. Chin J Child Health Care, 2010, 18(8): 724-726. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201008040.htm
[5]	WANG L, LI M, DILL S E, et al. Dynamic anemia status from infancy to preschool-age: evidence from rural China[J]. Int J Environ Res Public Health, 2019, 16(15): 2761. doi: 10.3390/ijerph16152761
[6]	ISLAM G. Association of socioeconomic status with childhood anemia among infant, toddler, and preschool children in Bangladesh[J]. Value Health Region Issues, 2020, 21(8): 141-148.
[7]	World Health Organization. Indicators for assessing infant and youngchild feeding practices part 2: measurement[M]. Geneva: World Health Organization, 2010.
[8]	中国营养学会膳食指南修订专家委员会妇幼人群指南修订专家工作组. 7~24月龄婴幼儿喂养指南[J]. 临床儿科杂志, 2016, 34(5): 381-387. doi: 10.3969/j.issn.1000-3606.2016.05.016 Working Group of Experts on Revision of Guidelines for Women andChildren of the Expert Committee of Revision of Dietary Guidelines of Chinese Nutrition Society. Guidelines for feeding infants 7 to 24 months of age[J]. J Clin Pediatr, 2016, 34(5): 381-387. doi: 10.3969/j.issn.1000-3606.2016.05.016
[9]	WGIER L P, KUBIAK M, LIEBERT A, et al. Ferrous sulfate oral solution in young children with iron deficiency anemia[J]. Pediatr Int, 2020, 62(7): 820-827. doi: 10.1111/ped.14237
[10]	董彩霞, 格鹏飞, 张丑吉, 等. 不同喂养方式和经济收入对婴幼儿贫血发生率的影响[J]. 卫生研究, 2013, 42(4): 596-599, 604. https://www.cnki.com.cn/Article/CJFDTOTAL-WSYJ201304017.htm DONG C X, GE P F, ZHANG C J, et al. Effects of different feedingpractices at 0-6 months and living economic conditions on anemiaprevalence of infants and young children[J]. J Hyg Res, 2013, 42(4): 596-599, 604. https://www.cnki.com.cn/Article/CJFDTOTAL-WSYJ201304017.htm
[11]	于春燕, 班文芬, 谢丽, 等. 贵州黔南地区农村少数民族6~23月龄儿童缺铁性贫血患病现状及其危险因素分析[J]. 中国公共卫生, 2018, 34(6): 812-816. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201806008.htm YU C Y, BAN W F, XIE L, et al. Prevalence and influence factors of iron deficiency anemia among 6-23 months old children in Qiannan area of Guizhou Province[J]. Chin J Public Health, 2018, 34(6): 812-816. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201806008.htm
[12]	杜亚琴. 武汉市江汉区36441名学龄前儿童健康检查结果分析[J]. 中国妇幼保健, 2021, 36(2): 5. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB202102048.htm DU Y Q. Analysis of health examination results of 36441 preschool children in Jianghan District, Wuhan City[J]. Matern Child Health Care China, 2021, 36(2): 5. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB202102048.htm
[13]	周旭, 方俊群, 罗家有, 等. 贫困农村地区6~23月龄婴幼儿贫血现况及影响因素[J]. 中国公共卫生, 2017, 33(9): 1302-1305. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201709003.htm ZHOU X, FANG J Q, LUO J Y, et al. Prevalence and influencing factors of anemia among 6-23 months old children in poor rural areas[J]. Chin J Public Health, 2017, 33(9): 1302-1305. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201709003.htm
[14]	阿不都外力·玉山. 1161名学龄前儿童血红蛋白调查报告[J]. 地方病通报, 2005, 21(2): 105-107. doi: 10.3969/j.issn.1000-3711.2005.02.043 ABUDUWAILI·YUSHAN. A survey report on hemoglobin in 1161 preschool children[J]. Bull Endem Dis, 2005, 21(2): 105-107. doi: 10.3969/j.issn.1000-3711.2005.02.043
[15]	连晓霞, 杨晓媛, 蒲小燕. 阿坝藏族羌族自治州7岁以下儿童贫血调查分析[J]. 中国妇幼保健, 2009, 24(1): 103-105. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB200901052.htm LIAN X X, YANG X Y, PU X Y. Aba Tibetan and Qiang Autono-mous Prefecture of anemia in children under the age of 7 survey analy-sis[J]. Matern Child Health Care Chin, 2009, 24(1): 103-105. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB200901052.htm
[16]	BEJARANO I F, OYHENART E E, TORRES M F, et al. Extended composite index of anthropometric failure in Argentinean preschool and school children[J]. Public Health Nutr, 2019, 22(18): 1-9.
[17]	刘月芬, 黄蕾, 张玲, 等. 甘肃省贫困地区婴幼儿喂养与喂养困难状况分析[J]. 中国儿童保健杂志, 2014, 22(5): 530-533. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201405029.htm LIU Y F, HUANG L, ZHANG L, et al. Feeding and feeding difficul-ties analysis of infants and young children in poor areas of Gansu Province[J]. Chin J Child Health Care, 2014, 22(5): 530-533. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201405029.htm
[18]	邢远, 颜虹, 党少农. 拉萨农村藏族婴幼儿母亲喂养知识和行为调查[J]. 中国公共卫生, 2010, 26(8): 945-946. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201008002.htm XING Y, YAN H, DANG S N. Knowledge and practice of child feed-ing among Tibet mothers with small children in Lhasa rural area[J]. Chin J Public Health, 2010, 26(8): 945-946. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201008002.htm
[19]	王治涛, 付晓荣, 黄中炎, 等. 母亲KAP模式干预对婴幼儿缺铁性贫血的影响研究[J]. 现代预防医学, 2015, 42(18): 3323-3325, 3335. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201518019.htm WANG Z T, FU X R, HUANG Z Y, et al. The effects of mother's KAB on infants with iron deficiency anemia[J]. Mod Prev Med, 2015, 42(18): 3323-3325, 3335. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201518019.htm
[20]	FANONY C, LAVINHA J, BRITO M, et al. Anemia in preschool children from Angola: a review of the evidence[J]. Port Biomedl J, 2020, 5(1): 1.