Sobrino M, Gutiérrez C, Alarcón J, Dávila M, Cunha A J
Pediatría, Facultad de Medicina, Universidad de Sevilla, Spain.
Sección Epidemiologia, Instituto Medicina Tropical, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Peru.
Child Care Health Dev. 2017 Jan;43(1):97-103. doi: 10.1111/cch.12420. Epub 2016 Nov 1.
Examine the evolution of stunting in <5 years of age in Peru and its relationship with birth interval (BI), and associated factors from 1996 to 2014.
Data were extracted from the National Demographic and Health Survey of Peru (DHS) for the years 1996, 2000, 2005, 2010 and 2014 on children <5 years of age for stunting (height / age ≤ 2DS). The main independent variable of interest was BI dichotomized by interval between date of last and penultimate birth (≤24 months vs. >24 months) and others sociodemographic variables. Crude and adjusted odds ratios with 95% confidence intervals were estimated in logistic regression for the effect of BI and other variables on stunting by each survey year.
Between 1996 and 2014, stunting declined in both BI groups: ≤24 months: 35.8% to 21.8%; >24 months: 29.5% to 14.3%. BI was associated with stunting after adjustment for other variables in each survey except 2005. Of the other factors, sex, birth order (fourth child or more), maternal education and poverty were independently associated with stunting in all survey years. Residence in rural areas and in Amazon forest and highland regions was associated with stunting 1996 and 2000. Maternal age was not independently associated with stunting.
While stunting showed a decreasing trend from 1996 to 2014, birth interval exceeding 24 months exerted a protective effect on stunting across the years surveyed. Poverty, low maternal education and high birth order were associated with stunting in all survey years.
研究1996年至2014年秘鲁5岁以下儿童发育迟缓的演变及其与生育间隔（BI）的关系以及相关因素。
从秘鲁全国人口与健康调查（DHS）中提取1996年、2000年、2005年、2010年和2014年5岁以下儿童发育迟缓（身高/年龄≤2标准差）的数据。主要的自变量是根据最后一次和倒数第二次分娩日期之间的间隔二分法划分的生育间隔（≤24个月与>24个月）以及其他社会人口学变量。通过逻辑回归估计每个调查年份生育间隔和其他变量对发育迟缓影响的粗比值比和调整后的比值比以及95%置信区间。
1996年至2014年期间，两个生育间隔组的发育迟缓率均有所下降：≤24个月组：从35.8%降至21.8%；>24个月组：从29.5%降至14.3%。除2005年外，在每次调查中，调整其他变量后生育间隔与发育迟缓相关。在所有其他因素中，性别、出生顺序（第四个孩子及以上）、母亲教育程度和贫困在所有调查年份均与发育迟缓独立相关。1996年和2000年，农村地区以及亚马逊森林和高地地区的居住情况与发育迟缓相关。母亲年龄与发育迟缓无独立关联。
虽然1996年至2014年期间发育迟缓呈下降趋势，但在所调查的年份中，生育间隔超过24个月对发育迟缓具有保护作用。在所有调查年份，贫困、母亲教育程度低和出生顺序高均与发育迟缓相关。
