Hong Seo Ah, Winichagoon Pattanee, Mongkolchati Aroonsri
ASEAN Institute for Health Development, Mahidol University, Salaya, Nakhon Pathom, Thailand. Email:
Institute for Health and Society, Hanyang University, Seoul, Korea.
Asia Pac J Clin Nutr. 2017 May;26(3):457-463. doi: 10.6133/apjcn.032016.06.
As tackling socioeconomic inequality in child malnutrition still remains one of the greatest challenges in developing countries, we examined maternal educational differences in malnutrition and the magnitude of its inequality among 4,198 children from the Prospective Cohort study of Thai Children (PCTC).
Prevalence of stunting, underweight, and wasting from birth to 24 months was calculated using the new WHO growth chart. The Relative Index of Inequality (RII) was used to examine the magnitude and trend of inequality in malnutrition between maternal educational levels.
The low education group had lower weight and height in most ages than the high education group. Faltering in height was observed in all education levels, but was most remarkable in the low education group. On the other hand, while upward trends for weight-for-age and weight-for-height across ages were observed in the high education group, a marked decline between 6 to 12 months was observed in the low education group. An increasing trend in inequality in The RII revealed an increasing trend in inequality in stunting, underweight, and wasting by maternal education levels was observed during infancy with an almost monotonic increase until 24 months, although the inequality in wasting decreased after 18 months of age.
Inequality in malnutrition remarkably increased during infancy, and for stunting and underweight it remained until 24 months. These findings shed light on the extent of malnutrition inequality during the first 2 years of life and they suggest sustainable efforts must be established at the national level to tackle the malnutrition inequality in infancy.
由于解决儿童营养不良方面的社会经济不平等问题仍是发展中国家面临的最大挑战之一，我们在泰国儿童前瞻性队列研究（PCTC）的4198名儿童中，研究了营养不良方面的母亲教育差异及其不平等程度。
使用世界卫生组织新的生长图表计算出生至24个月的发育迟缓、体重不足和消瘦患病率。不平等相对指数（RII）用于研究母亲教育水平之间营养不良不平等的程度和趋势。
在大多数年龄段，低教育组的体重和身高低于高教育组。所有教育水平的儿童均出现身高增长缓慢的情况，但在低教育组最为明显。另一方面，高教育组各年龄段的年龄别体重和身高别体重呈上升趋势，而低教育组在6至12个月时则出现明显下降。RII不平等的增加趋势显示，在婴儿期，发育迟缓、体重不足和消瘦的不平等程度呈上升趋势，直至24个月几乎呈单调增加，尽管消瘦的不平等在18个月后有所下降。
营养不良的不平等在婴儿期显著增加，发育迟缓和体重不足的不平等一直持续到24个月。这些发现揭示了生命最初两年营养不良不平等的程度，并表明必须在国家层面做出持续努力，以解决婴儿期的营养不良不平等问题。
