Pei Leilei, Ren Lin, Wang Duolao, Yan Hong
a Department of Epidemiology and Health Statistics, School of Public Health , Xi'an Jiaotong University College of Medicine , Xi'an , Shaanxi , P.R. China.
Ethn Health. 2014 Jun;19(3):297-310. doi: 10.1080/13557858.2013.776012. Epub 2013 Mar 7.
The double burden of undernutrition and overnutrition is recognized as a global devastating problem. However, few studies have investigated the maternal nutritional status among different ethnicities and the socio-demographic characteristics in rural areas of western China. This study attempted to fill this gap.
Data on 10,495 women with children under three years old were collected using a three-stage probability proportion to size sampling from 45 counties of 10 provinces in western China. Generalized Estimating Equation (GEE) was used to assess the maternal nutrition conditions, including chronic energy deficiency (CED) and overweight/obesity.
According to the WHO BMI standard, the prevalences of CED and overweight/obesity were 12.3% (BMI≤18.5 kg/m2) and 12.4% (BMI≥25 kg/m2), respectively, while overweight/obesity rate was 18.5% (BMI≥24 kg/m2) based on the Chinese standard. A significant difference in malnutrition between Han and Minority was not observed. The relationship between breastfeeding and CED was inverse (OR 0.64, 95%CI: 0.48, 0.87), but higher parity were positively correlated with CED (OR 1.57, 95%CI: 1.36, 1.82). The highest odds of CED were observed in the group with 1-5 years of education (OR 1.21, 95%CI: 1.03, 1.43). Higher parity was also associated with overweight/obesity (OR 0.78, 95%CI: 0.67, 0.91), and rural women aged 30-39 years old were more likely to be overweight/obese (OR 2.21, 95%CI: 1.47, 3.32). In addition, higher socioeconomic status was positively related to overweight women (OR 1.19, 95%CI: 1.01, 1.43), and inversely associated with CED (OR 0.83, 95%CI: 0.72, 0.97).
The coexistence of undernutrition and overweight among women of reproductive age are determined in rural western China. It appears that socio-demographic factors considerably influence maternal nutritional status in the study. These findings have important policy implications for recommendations on maternal health intervention in China.
营养不良和营养过剩的双重负担被认为是一个全球性的灾难性问题。然而，很少有研究调查中国西部农村地区不同民族的孕产妇营养状况以及社会人口学特征。本研究试图填补这一空白。
采用三阶段规模概率抽样方法，从中国西部10个省份的45个县收集了10495名有3岁以下子女的妇女的数据。使用广义估计方程（GEE）评估孕产妇营养状况，包括慢性能量缺乏（CED）和超重/肥胖。
根据世界卫生组织的BMI标准，CED和超重/肥胖的患病率分别为12.3%（BMI≤18.5kg/m²）和12.4%（BMI≥25kg/m²），而根据中国标准，超重/肥胖率为18.5%（BMI≥24kg/m²）。未观察到汉族和少数民族在营养不良方面存在显著差异。母乳喂养与CED呈负相关（OR=0.64，95%CI：0.48，0.87），但较高的产次与CED呈正相关（OR=1.57，95%CI：1.36，1.82）。在受教育1-5年的人群中观察到CED的最高比值比（OR=1.21，95%CI：1.03，1.43）。较高的产次也与超重/肥胖有关（OR=0.78，95%CI：0.67，0.91），30-39岁的农村妇女超重/肥胖的可能性更大（OR=2.21，95%CI：1.47，3.32）。此外，较高的社会经济地位与超重妇女呈正相关（OR=1.19，95%CI：1.01，1.43），与CED呈负相关（OR=0.83，95%CI：0.72，0.97）。
中国西部农村地区育龄妇女中存在营养不良和超重并存的情况。在该研究中，社会人口学因素似乎对孕产妇营养状况有很大影响。这些发现对中国孕产妇健康干预建议具有重要的政策意义。
