Developmental status of iron deficiency anemia and factors among preschool children in Dongguan
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摘要:
目的 分析东莞地区学龄前儿童缺铁性贫血的影响因素及其身心发育情况，为学龄前儿童缺铁性贫血的预防提供参考。 方法 纳入2022年1—12月在东莞市妇幼保健院体检的学龄前缺铁性贫血儿童118例为贫血组，另取同期在院体检的学龄前健康儿童118例为对照组，利用年龄与发育进程问卷评估两组儿童身心发育情况，收集年龄、性别、家庭人均收入等资料进行缺铁性贫血发生的单因素分析和多因素Logistic回归分析。 结果 贫血组儿童精细动作、大运动、适应能力、社会交往、语言能力及发育商得分均低于对照组(t值分别为4.14，5.46，5.60，5.50，4.90，5.83，P值均＜0.01)；贫血组3，4，5，6岁儿童与对照组儿童适应能力、精细动作、大运动、语言能力、社会交往各能区评分差值及发育商评分差值从高至低依次为6，5，4，3岁(F值分别为390.56，414.63，437.35，409.68，407.20，404.54，P值均＜0.01)。多因素Logistic回归分析提示，家庭月收入、消化疾病史、孕周、母亲孕期贫血史、母亲学历、肉蛋奶食物摄入情况、坚果类食物摄入情况均为东莞地区学龄前儿童发生缺铁性贫血的影响因素(OR值分别为2.23，2.99，3.99，3.56，3.11，1.68，1.61，P值均＜0.05)。 结论 东莞地区学龄前缺铁性贫血儿童身心发育较同龄非贫血儿童更慢，且随年龄增长与同龄健康儿童相比发育滞后情况越明显。应重视学龄前儿童缺铁性贫血的预防，针对有消化疾病史、早产儿等高危因素的儿童，需重视其饮食方案的合理规划。 Abstract:Objective To analyze the influencing factors and physical and mental development of preschool children with iron deficiency anemia in Dongguan, so as to provide a reference for the prevention of iron deficiency anemia among preschool children. Methods A total of 118 preschool children with iron deficiency anemia who were examined in Dongguan Maternal and Child Health Center from January 2022 to December 2022 were enrolled in the anemia group, and 118 preschool healthy children who were examined in the hospital at the same time were enrolled in the control group. The physical and mental development of the children were evalucded in both groups. Demographic information and household per capita income were collected. The relationship between risk factors and iron deficiency anemia was analyzed by univariate analysis and multiple Logistic regression. Results The scores of fine motor skills, gross motor skills, adaptability, social communication, language ability and developmental quotient of children in anemia group were significantly lower than those in control group (t=4.14, 5.46, 5.60, 5.50, 4.90, 5.83, P < 0.01). The difference in scores of adaptability, fine motor skills, gross motor skills language ability, social communication and developmental quotient between the two groups increased with age (F=390.56, 414.63, 437.35, 409.68, 407.20, 404.54, P < 0.05). Multivariate Logistic regression analysis showed that household income, history of past digestive disease, gestational age, maternal anemia during pregnancy, maternal education, consumption of meat, eggs and milk, and intake of nuts were all associated with iron deficiency anemia among preschool children in Dongguan (OR=2.23, 2.99, 3.99, 3.56, 3.11, 1.68, 1.61, P < 0.05). Conclusion The physical and mental development of preschool children with iron deficiency anemia in Dongguan is slower than that of non-anemia children of the same age, and the development delay becomes more obvious with increasing age. Attention should be paid to the prevention of iron deficiency anemia among preschool children. It is important to provide reasonable dietary guidance for children with high-risk factors such as digestive disease history and prematurity. -
Key words:
- Anemia, iron-deficiency /
- Case-control studies /
- Regression analysis /
- Child, preschool
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表 1 东莞地区学龄前缺铁性贫血儿童与同龄健康儿童年龄与发育进程问卷得分比较(x ±s)
Table 1. Comparison of age and development progress questionnaire scores between preschool iron deficiency anemia children and healthy children of the same age in Dongguan Area(x ±s)
组别 人数 适应能力 语言能力 精细运作 大运动 社会交往 发育商 对照组 118 44.36±5.15 46.64±5.71 44.96±5.65 42.03±4.36 43.01±4.85 221.52±23.41 贫血组 118 41.64±4.93 42.82±5.01 41.05±5.07 39.03±4.01 40.07±4.36 204.61±21.07 t值 4.14 5.46 5.60 5.50 4.90 5.83 P值 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 
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表 2 东莞地区不同年龄学龄前缺铁性贫血儿童与对照组儿童年龄与发育进程问卷得分差值比较(x ±s)
Table 2. Comparison of the score difference of age and developmental progress questionniare between preschool children with iron deficiency anemia children of different ages and the control group in Dongguan Area(x ±s)
年龄/岁 人数 适应能力 语言能力 精细运作 大运动 社会交往 发育商 3 20 0.89±0.15 1.36±0.23 1.05±0.18 0.96±0.21 0.89±0.18 5.15±1.05 4 23 1.49±0.27 2.47±0.32 2.63±0.30 1.64±0.28 1.75±0.21 9.98±1.35 5 41 3.25±0.41 4.36±0.49 4.85±0.52 3.47±0.45 3.42±0.44 19.35±2.03 6 34 3.99±0.48 5.53±0.61 5.32±0.63 4.55±0.53 4.37±0.52 23.76±3.05 F值 390.56 414.63 437.35 409.68 407.20 404.54 P值 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01
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表 3 东莞地区学龄前儿童发生缺铁性贫血的单因素分析
Table 3. Sigle-factor analysis of iron deficiency anemia in preschool children in Dongguan
组别 人数 性别 年龄/岁 家庭月收入/元 孕周 户籍 男童 女童 ≤4 >4 ≥5 000 < 5000 早产 足月 城镇 农村 缺铁性贫血 118 61(51.69) 57(48.31) 43(36.44) 75(63.56) 40(33.90) 78(66.10) 51(43.22) 67(56.78) 60(56.78) 58(43.22) 非缺铁性盆血 118 63(53.39) 55(46.61) 40(33.90) 78(66.10) 56(47.46) 62(52.54) 20(16.95) 98(57.63) 64(54.24) 54(45.76) χ2值 0.07 0.17 4.50 19.36 0.27 P值 0.79 0.68 0.03 < 0.01 0.60 组别 人数 母亲孕期贫血史 消化疾病史 母亲学历 坚果类食物摄入情况 肉蛋奶类食物摄入情况 有 无 有 无 高中 大专及以上 充足 不足 充足 不足 缺铁性贫血 118 84(71.19) 34(28.81) 88(74.58) 30(25.42) 79(66.95) 39(33.05) 64(54.24) 54(45.76) 75(63.56) 43(36.44) 非缺铁性贫血 118 49(41.53) 69(58.47) 64(54.24) 54(45.76) 49(41.53) 69(58.47) 87(37.73) 31(26.27) 99(83.90) 19(16.10) χ2值 21.10 10.65 15.37 9.73 12.60 P值 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 注：()内数字为构成比/%。
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表 4 东莞地区学龄前儿童发生缺铁性贫血的多因素Logistic回归分析(n=236)
Table 4. Multivariate Logistic regression analysis of iron deficiency anemia among preschool children in Dongguan(n=236)
自变量 β值 标准误 Wald χ2值 P值 OR值(95%CI) 家庭收入 0.44 0.23 8.62 0.01 2.05(1.25~2.85) 消化疾病史 0.35 0.26 10.25 0.02 1.96(1.24~2.69) 孕周 0.71 0.43 18.36 0.01 3.98(2.01~5.94) 母亲孕期贫血史 0.65 0.25 6.35 ＜0.01 3.47(1.30~5.63) 母亲学历 0.63 0.63 3.69 0.03 3.13(1.63~4.62) 肉蛋奶类食物摄取情况 0.46 0.36 14.14 ＜0.01 2.26(1.52~3.00) 坚果类食物摄入情况 0.45 0.25 9.05 0.01 2.17(1.19~3.15)
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