Aguayo Victor M, Badgaiyan Nina, Paintal Kajali
United Nations Children's Fund (UNICEF), Regional Office for South Asia, Kathmandu, Nepal.
Matern Child Nutr. 2015 Jul;11(3):333-45. doi: 10.1111/mcn.12168. Epub 2014 Dec 23.
Stunting is associated with poor survival and development in children. Our analysis identifies the factors most significantly associated with child stunting in Bhutan using a nationally representative sample of 2085 children 0-23 months old. We find that 27.5% of children were stunted and almost half (42.6%) of the stunted children were severely stunted. Children's mean height-for-age z-score deteriorated significantly with age (from -0.23 in infants 0-5 months old to -1.60 in children 18-23 months old) and levels of severe stunting were significantly higher among boys. Multivariate regression analysis indicates that children from the Eastern/Western regions had a 64% higher odds of being stunted than children from the Central region (OR 1.64; 95% CI 1.29-2.07); similarly, children from the two lower wealth quintiles had 37% higher odds of being stunted than children from the two upper wealth quintiles (OR 1.37; 95% CI 1.00-1.87). Children whose mothers received three or fewer antenatal care visits during the last pregnancy had a 31% higher odds of being stunted (OR 1.31; 95% CI 1.01-1.69) while children whose mothers did not receive antenatal care from a doctor, nurse or midwife had a 51% higher odds of being stunted (OR 1.51; 95% CI 1.18-1.92). Recommended complementary feeding practices tended to be associated with lower odds of stunting, particularly in the first year of life. Specifically, children who were not fed complementary foods at 6-8 months had about threefold higher odds of being severely stunted than children who were fed complementary foods (OR 2.73; 95% CI 1.06-7.02).
发育迟缓与儿童生存及发育不良有关。我们的分析使用了2085名0至23个月大儿童的全国代表性样本，确定了不丹与儿童发育迟缓最显著相关的因素。我们发现，27.5%的儿童发育迟缓，近一半（42.6%）发育迟缓儿童为重度发育迟缓。儿童的身高别年龄标准差随年龄显著恶化（从0至5个月婴儿的-0.23降至18至23个月儿童的-1.60），重度发育迟缓水平在男孩中显著更高。多变量回归分析表明，东部/西部地区的儿童发育迟缓几率比中部地区的儿童高64%（比值比1.64；95%置信区间1.29 - 2.07）；同样，两个较低财富五分位数组的儿童发育迟缓几率比两个较高财富五分位数组的儿童高37%（比值比1.37；95%置信区间1.00 - 1.87）。母亲在上次怀孕期间接受三次或更少产前检查的儿童发育迟缓几率高31%（比值比1.31；95%置信区间1.01 - 1.69），而母亲未接受医生、护士或助产士产前检查的儿童发育迟缓几率高51%（比值比1.51；95%置信区间1.18 - 1.92）。推荐的辅食喂养方式往往与发育迟缓几率较低相关，尤其是在生命的第一年。具体而言，6至8个月未喂养辅食的儿童重度发育迟缓几率比喂养辅食的儿童高约三倍（比值比2.73；95%置信区间1.06 - 7.02）。
