Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.
Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, South Korea.
Matern Child Nutr. 2019 Oct;15(4):e12821. doi: 10.1111/mcn.12821. Epub 2019 Apr 24.
The prevalence of childhood stunting in Myanmar is one of the highest among the countries of Southeast Asia. Cross-sectional data from the Myanmar Demographic Health Survey 2015-2016 were used to examine risk factors for stunting, wasting, and underweight among children aged 0-59 months. The prevalence of stunting, wasting, and underweight was 29.0%, 7.3%, and 19.2%, respectively. Accounting for sampling design and weights, multivariable logistic regression was conducted with 35 household, maternal, and child characteristics. Current pregnancy and maternal height <145 cm, home delivery, child's small birth size recalled by mother, and older age (ref: 0-5 months) predicted both stunting and underweight. Larger than average birth size was protective for all stunting, wasting, and underweight. Maternal body mass index <18.5 kg m was a common risk factor for wasting and underweight. Lower wealth quintiles, maternal engagement in nonagricultural occupation, and male child predicted stunting only. Younger child age and not receiving vitamin A supplementation in the previous 6 months were risk factors for wasting only. Regional variation was also seen, with a higher odds of stunting in the West-South Region, North-East States, and West States, compared with the Central Regions. In Myanmar, socio-economic and demographic factors, poor maternal nutritional status, and living in certain geographical locations are affecting children's undernutrition. It is recommended that interventions for growth faltering focus on the first 1,000 days of life; optimum maternal nutrition be ensured during and before pregnancy and at adolescence; societal support be provided for mothers in poverty or engaged in nonagriculture; and region-specific undernutrition pathways be understood.
缅甸儿童发育迟缓的患病率在东南亚国家中是最高的之一。使用 2015-2016 年缅甸人口健康调查的横断面数据,研究了 0-59 月龄儿童发育迟缓、消瘦和体重不足的危险因素。发育迟缓、消瘦和体重不足的患病率分别为 29.0%、7.3%和 19.2%。考虑到抽样设计和权重,对 35 个家庭、产妇和儿童特征进行了多变量逻辑回归分析。当前妊娠和母亲身高<145cm、家庭分娩、母亲回忆孩子出生时较小的体型以及年龄较大(参考:0-5 个月)均预测发育迟缓及体重不足。出生时体型较大对所有发育迟缓、消瘦和体重不足均有保护作用。母亲身体质量指数<18.5kg/m 是消瘦和体重不足的常见危险因素。较低的财富五分位数、母亲从事非农业职业以及男孩是发育迟缓的唯一预测因素。年龄较小的儿童和在前 6 个月未接受维生素 A 补充剂是消瘦的唯一危险因素。还观察到区域差异,与中部地区相比,西部地区、东北部各州和西部各州发育迟缓的可能性更高。在缅甸,社会经济和人口因素、产妇营养状况差以及居住在某些地理位置,都影响着儿童的营养不良。建议将生长迟缓的干预措施重点放在生命最初的 1000 天;确保孕妇和青春期期间以及之前的最佳产妇营养;为贫困或从事非农业的母亲提供社会支持;并了解特定区域的营养不良途径。