Freitas Brunnella Alcantara Chagas de, Lima Luciana Moreira, Moreira Maria Elisabeth Lopes, Priore Silvia Eloiza, Henriques Bruno David, Carlos Carla Fernanda Lisboa Valente, Sabino Jusceli Souza Nogueira, Franceschini Sylvia do Carmo Castro
Universidade Federal de Viçosa (UFV), Departamento de Medicina e Enfermagem, Viçosa/MG, Brazil.
Fundação Oswaldo Cruz, Instituto Fernandes Figueira, Rio de Janeiro/RJ, Brazil.
Clinics (Sao Paulo). 2016 Aug;71(8):440-8. doi: 10.6061/clinics/2016(08)06.
To analyze adherence to the recommended iron, zinc and multivitamin supplementation guidelines for preemies, the factors associated with this adherence, and the influence of adherence on the occurrence of anemia and iron, zinc and vitamin A deficiencies.
This prospective cohort study followed 58 preemies born in 2014 until they reached six months corrected age. The preemies were followed at a referral secondary health service and represented 63.7% of the preterm infants born that year. Outcomes of interest included high or low adherence to iron, zinc and multivitamin supplementation guidelines; prevalence of anemia; and prevalences of iron, zinc, and vitamin A deficiencies. The prevalence ratios were calculated by Poisson regression.
Thirty-eight (65.5%) preemies presented high adherence to micronutrient supplementation guidelines. At six months of corrected age, no preemie had vitamin A deficiency. The prevalences of anemia, iron deficiency and zinc deficiency were higher in the low-adherence group but also concerning in the high-adherence group. Preemies with low adherence to micronutrient supplementation guidelines were 2.5 times more likely to develop anemia and 3.1 times more likely to develop zinc deficiency. Low maternal education level increased the likelihood of nonadherence to all three supplements by 2.2 times.
Low maternal education level was independently associated with low adherence to iron, zinc and vitamin A supplementation guidelines in preemies, which impacted the prevalences of anemia and iron and zinc deficiencies at six months of corrected age.
分析早产儿对推荐的铁、锌和多种维生素补充指南的依从性、与这种依从性相关的因素,以及依从性对贫血、铁、锌和维生素A缺乏症发生情况的影响。
这项前瞻性队列研究对2014年出生的58名早产儿进行随访,直至他们达到矫正年龄6个月。这些早产儿在一家二级转诊医疗服务机构接受随访,占当年出生的早产儿的63.7%。感兴趣的结果包括对铁、锌和多种维生素补充指南的高依从性或低依从性;贫血患病率;以及铁、锌和维生素A缺乏症的患病率。患病率比值通过泊松回归计算。
38名(65.5%)早产儿对微量营养素补充指南表现出高依从性。在矫正年龄6个月时,没有早产儿患有维生素A缺乏症。低依从性组的贫血、缺铁和缺锌患病率较高,但高依从性组的情况也令人担忧。对微量营养素补充指南依从性低的早产儿患贫血的可能性高2.5倍,患锌缺乏症的可能性高3.1倍。母亲教育水平低使不依从所有三种补充剂的可能性增加2.2倍。
母亲教育水平低与早产儿对铁、锌和维生素A补充指南的低依从性独立相关,这影响了矫正年龄6个月时贫血、铁缺乏和锌缺乏的患病率。