出生体重、HIV 暴露和婴儿喂养方式对博茨瓦纳婴儿营养不良的预测作用。

Birthweight, HIV exposure and infant feeding as predictors of malnutrition in Botswanan infants.

机构信息

Division of Nutritional Sciences, School of Biosciences, University of Nottingham, Loughborough, UK.

School of Life Sciences, Coventry University, Coventry, UK.

出版信息

J Hum Nutr Diet. 2017 Dec;30(6):779-790. doi: 10.1111/jhn.12517. Epub 2017 Sep 28.

DOI:10.1111/jhn.12517

PMID:28960594

Abstract

BACKGROUND

A better understanding of the nutritional status of infants who are HIV-Exposed-Uninfected (HEU) and HIV-Unexposed-Uninfected (HUU) during their first 1000 days is key to improving population health, particularly in sub-Saharan Africa.

METHODS

A cross-sectional study compared the nutritional status, feeding practices and determinants of nutritional status of HEU and HUU infants residing in representative selected districts in Botswana during their first 1000 days of life. Four hundred and thirteen infants (37.3% HIV-exposed), aged 6-24 months, attending routine child health clinics, were recruited. Anthropometric, 24-h dietary intake and socio-demographic data was collected. Anthropometric Z-scores were calculated using 2006 World Health Organization growth standards. Modelling of the determinants of malnutrition was undertaken using logistic regression.

RESULTS

Overall, the prevalences of stunting, wasting and being underweight were 10.4%, 11.9% and 10.2%, respectively. HEU infants were more likely to be underweight (15.6% versus 6.9%), (P < 0.01) and stunted (15.6% versus 7.3%), (P < 0.05) but not wasted (P = 0.14) than HUU infants. HEU infants tended to be formula fed (82.5%), whereas HUU infants tended to breastfeed (94%) for the first 6 months (P < 0.001). Significant predictors of nutritional status were HIV exposure, birthweight, birth length, APGAR (appearance, pulse, grimace, activity and respiration) score and mother/caregiver's education with little influence of socio-economic status.

CONCLUSIONS

HEU infants aged 6-24 months had worse nutritional status compared to HUU infants. Low birthweight was the main predictor of undernutrition in this population. Optimisation of infant nutritional status should focus on improving birthweight. In addition, specific interventions should target HEU infants aiming to eliminate growth disparity between HEU and HUU infants.

摘要

背景

更好地了解在头 1000 天内 HIV 暴露但未感染（HEU）和未暴露但未感染（HUU）婴儿的营养状况，对于改善人口健康至关重要，尤其是在撒哈拉以南非洲地区。

方法

一项横断面研究比较了居住在博茨瓦纳代表性选定地区的 HEU 和 HUU 婴儿在生命的头 1000 天内的营养状况、喂养方式和营养状况决定因素。招募了 413 名 6-24 个月大的婴儿（37.3%暴露于 HIV），他们在常规儿童保健诊所就诊。收集了人体测量学、24 小时饮食摄入和社会人口统计学数据。使用 2006 年世界卫生组织生长标准计算人体测量学 Z 分数。使用逻辑回归对营养不良的决定因素进行建模。

结果

总体而言，发育迟缓、消瘦和体重不足的患病率分别为 10.4%、11.9%和 10.2%。与 HUU 婴儿相比，HEU 婴儿更有可能体重不足（15.6%比 6.9%），（P<0.01）和发育迟缓（15.6%比 7.3%），（P<0.05），但不消瘦（P=0.14）。HEU 婴儿倾向于配方奶喂养（82.5%），而 HUU 婴儿倾向于母乳喂养（94%）在头 6 个月（P<0.001）。营养状况的显著预测因素是 HIV 暴露、出生体重、出生长度、APGAR（外观、脉搏、面部表情、活动和呼吸）评分以及母亲/照顾者的教育，社会经济地位的影响很小。