Huey Samantha Lee, Finkelstein Julia Leigh, Venkatramanan Sudha, Udipi Shobha A, Ghugre Padmini, Thakker Varsha, Thorat Aparna, Potdar Ramesh D, Chopra Harsha V, Kurpad Anura V, Haas Jere Douglas, Mehta Saurabh
Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States.
Institute for Nutritional Sciences, Global Health, and Technology (INSIGHT), Cornell University, Ithaca, NY, United States.
Front Public Health. 2019 Jul 12;7:191. doi: 10.3389/fpubh.2019.00191. eCollection 2019.
Young children living in urban slums are vulnerable to malnutrition and subsequently poor health outcomes, but data on the correlates of stunting, underweight, wasting, and anemia specifically among 10-18 month-old children in India remain limited. In this analysis, we sought to describe the prevalence of and examine correlates for different markers of undernutrition, including stunting, underweight, and anemia among 10-18 month-old children living in urban slums, an understudied vulnerable group. Children and their mothers ( = 323) were screened for anthropometry, demographics, and complete blood counts for hemoglobin concentration between March and November 2017 (Clinicaltrials.gov ID: NCT02233764). Correlates included child and mother's age, sex, birth order, birth weight, illness episodes, hemoglobin concentration, family income, maternal height, and maternal education level. Risk ratios (RR, 95% CI) for binary outcomes (stunting, underweight, wasting and anemia) and mean differences (β, 95% CI) for continuous outcomes (anthropometric Z-scores, hemoglobin concentration) were calculated using multivariate binomial and linear regression (SAS 9.4). The prevalence of stunting was 31.2%, underweight 25.1%, wasting (9.0%), and anemia (76%) among all children. Male children had a higher prevalence of poor growth indices and lower anthropometric Z-scores than females. Male sex, low birthweight, shorter maternal height, report of ≥1 episodes of illness within the past month, older maternal age, and birth order ≥2 were also associated with poor growth and anemia in multivariate models. Correlates of undernutrition were different among females and males. Female children had a 40% (20, 60%) higher risk of anemia associated with diarrhea, and male children who were firstborn had a 20% (0, 70%) lower risk of anemia. These results show that poor growth and anemia among young children is prevalent in urban slums of Mumbai, and that sex of the child may play an important role in informing interventions to address undernutrition.
生活在城市贫民窟的幼儿易患营养不良，进而导致健康状况不佳，但关于印度10至18个月大儿童发育迟缓、体重不足、消瘦和贫血相关因素的数据仍然有限。在本分析中，我们试图描述城市贫民窟中10至18个月大儿童这一研究较少的弱势群体中不同营养不良指标的患病率，并研究其相关因素。2017年3月至11月期间，对儿童及其母亲（n = 323）进行了人体测量、人口统计学和血红蛋白浓度全血细胞计数筛查（Clinicaltrials.gov标识符：NCT02233764）。相关因素包括儿童和母亲的年龄、性别、出生顺序、出生体重、疾病发作次数、血红蛋白浓度、家庭收入、母亲身高和母亲教育水平。使用多变量二项式和线性回归（SAS 9.4）计算二元结局（发育迟缓、体重不足、消瘦和贫血）的风险比（RR，95%置信区间）以及连续结局（人体测量Z评分、血红蛋白浓度）的均值差异（β，95%置信区间）。所有儿童中发育迟缓的患病率为31.2%，体重不足为25.1%，消瘦为9.0%，贫血为76%。男童生长指标不良的患病率高于女童，人体测量Z评分低于女童。在多变量模型中，男性性别、低出生体重、母亲身高较矮、过去一个月内报告有≥1次疾病发作、母亲年龄较大以及出生顺序≥2也与生长不良和贫血有关。营养不良的相关因素在女性和男性中有所不同。女童因腹泻患贫血的风险高40%（20%，60%），头胎男童患贫血的风险低20%（0%，70%）。这些结果表明，孟买城市贫民窟中幼儿生长不良和贫血很普遍，儿童性别可能在为解决营养不良问题的干预措施提供依据方面发挥重要作用。
