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[两岁以下儿童体重及线性生长不足的决定因素]

[Determinants of weight and linear growth deficits in children under two years of age].

作者信息

Oliveira Valterlinda Alves de, Assis Ana Marlúcia Oliveira, Pinheiro Sandra Maria Conceição, Barreto Mauricio Lima

机构信息

Escola de Nutrição, Universidade Federal da Bahia, Rua Araújo Pino 32, Canela, 40110-150 Salvador, BA, Brasil.

出版信息

Rev Saude Publica. 2006 Oct;40(5):874-82. doi: 10.1590/s0034-89102006000600018.

Abstract

OBJECTIVE

To identify determinants of protein-energy malnutrition resulting in weight and linear growth deficits in children.

METHODS

A cross-sectional study was carried out among 1,041 children (under two years of age) from 10 municipalities in Bahia, Northeastern Brazil, during 1999-2000. Both logistic regression and a hierarchical approach were used to identify factors associated with the anthropometric measures.

RESULTS

The basic determinant found in the final model for linear growth retardation was having up to two household appliances (OR=2.9; 95% CI: 1.74-4.90); as an underlying determinant, not attending prenatal visits (OR=2.7; 95% CI: 1.47-4.97); and, among immediate determinants were low birth weight (OR=3.6; 95% CI: 1.72-7.70) and reported hospitalization within 12 months before the interview (OR=2.4; 95% CI: 1.42-4.10). Determinants of weight deficit at the basic, underlying and immediate levels were: per capita monthly income of less than one-fourth of the minimum wage (OR=3.4; 95% CI: 1.41-8.16), not attending prenatal visits (OR=2.1; 95% CI: 1.03-4.35) and low birth weight (OR=4.8; 95% CI: 2.00-11.48) respectively.

CONCLUSIONS

Children's weight and linear deficits were accounted for the overlapping of poor material living conditions, limited access to health care and disease burden. Interventions aimed at improving living conditions and better access to health care programs are strategies towards equity in children's health and nutrition.

摘要

目的

确定导致儿童体重和线性生长发育迟缓的蛋白质-能量营养不良的决定因素。

方法

1999年至2000年期间,在巴西东北部巴伊亚州10个市的1041名两岁以下儿童中开展了一项横断面研究。采用逻辑回归和分层方法来确定与人体测量指标相关的因素。

结果

在最终的线性生长发育迟缓模型中发现的基本决定因素是家庭拥有的家用电器不超过两件(比值比=2.9;95%置信区间:1.74-4.90);作为潜在决定因素,未进行产前检查(比值比=2.7;95%置信区间:1.47-4.97);而在直接决定因素中,低出生体重(比值比=3.6;95%置信区间:1.72-7.70)以及在访谈前12个月内有住院记录(比值比=2.4;95%置信区间:1.42-4.10)。体重不足在基本、潜在和直接层面的决定因素分别为:人均月收入低于最低工资的四分之一(比值比=3.4;95%置信区间:1.41-8.16)、未进行产前检查(比值比=2.1;95%置信区间:1.03-4.35)和低出生体重(比值比=4.8;95%置信区间:2.00-11.48)。

结论

儿童的体重和线性生长发育迟缓是由恶劣的物质生活条件、获得医疗保健的机会有限以及疾病负担相互重叠导致的。旨在改善生活条件和更好地获得医疗保健项目的干预措施是实现儿童健康和营养公平的策略。

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