父母外出务工对农村留守儿童早期营养的影响。
The association between parental migration and early childhood nutrition of left-behind children in rural China.
机构信息
Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
Section of Health, Nutrition, and Water, Environment and Sanitation, UNICEF China, 12 Sanlitun Road, Chao Yang District, Beijing, 100600, China.
出版信息
BMC Public Health. 2020 Feb 18;20(1):246. doi: 10.1186/s12889-020-8350-4.
BACKGROUND
More than one-third of children under 3 years old are left behind at home due to parental migration in rural China, and we know very little about early childhood nutrition of left-behind children (LBC) because of the dearth of research. This study examined the association between parental migration and early childhood nutrition of LBC in rural China.
METHODS
We used repeated cross-sectional data of rural children aged 6-35 months who participated in two surveys in six counties of northern and southern China in 2013 and 2016 respectively. The length, weight, and hemoglobin concentration were measured by trained health-care workers blinded to parental migration status. Stunting, underweight, wasting, and anemia were identified with the standards recommended by WHO. Generalized linear regressions and multivariate logistic regressions were employed to explore the association between parental migration and these nutritional outcomes at each time point.
RESULTS
Two thousand three hundred thirty-six and 2210 children aged 6-35 months were enrolled in 2013 and 2016, respectively. The results show a reduction of the risks of stunting, underweight, and wasting from 2013 (16.4, 8.5, and 3.5%, respectively) to 2016 (12.1, 4.0, and 1.5%, respectively) but highlight a constantly and alarmingly high risk of anemia among these children (44.8% in 2013 and 43.8% in 2016). Children with migrant fathers performed as well as or better than those with non-migrants on these indicators. Children with migrant parents performed slightly worse in 2013, but equal or slightly superior in 2016 on these indicators compared with children with non-migrants and migrant fathers. Children aged 6-17 months with migrant parents had a significantly lower risk of anemia than those living with their mothers or with both parents (43.1% vs. 63.6% and 61.5 in 2013, and 42.5 vs. 60.1 and 66.2% in 2016), even after controlling for children's sociodemographic characteristics.
CONCLUSIONS
Parental migration may be not detrimental and even beneficial to early childhood nutrition of LBC in rural China. Continued nutritional support is needed for all rural children, especially interventions for preventing micronutrient deficiency. Programs for LBC are recommended to continue to focus on nutrition but pay more attention to other important health issues.
背景
在中国农村，由于父母外出务工，超过三分之一的 3 岁以下儿童被留在家里，由于缺乏研究，我们对留守儿童的幼儿期营养知之甚少。本研究旨在探讨父母外出务工与中国农村留守儿童幼儿期营养之间的关系。
方法
我们使用了 2013 年和 2016 年分别在北方和南方六个县参加两次调查的 6-35 月龄农村儿童的重复横断面数据。经过培训的医护人员对儿童的身长、体重和血红蛋白浓度进行了测量，他们对父母外出务工的情况并不知情。使用世界卫生组织推荐的标准来确定发育迟缓、消瘦、消瘦和贫血。采用广义线性回归和多变量逻辑回归来探讨父母外出务工与各时间点营养结局之间的关系。
结果
分别有 2336 名和 2210 名 6-35 月龄儿童参加了 2013 年和 2016 年的研究。结果显示，从 2013 年（分别为 16.4%、8.5%和 3.5%）到 2016 年（分别为 12.1%、4.0%和 1.5%），发育迟缓、消瘦和消瘦的风险有所降低，但这些儿童的贫血风险一直很高且令人震惊（2013 年为 44.8%，2016 年为 43.8%）。有外出务工父亲的儿童在这些指标上的表现与没有外出务工的儿童一样好或更好。与没有外出务工的父母和只有父亲外出务工的儿童相比，父母双方都外出务工的儿童在 2013 年的表现稍差，但在 2016 年的表现相当或稍好。与母亲或父母双方都留守的儿童相比，父母双方都外出务工的 6-17 月龄儿童贫血的风险显著降低（2013 年分别为 43.1%、63.6%和 61.5%，2016 年分别为 42.5%、60.1%和 66.2%），即使在控制了儿童的社会人口特征后也是如此。
结论
父母外出务工可能对中国农村留守儿童的幼儿期营养没有不利影响，甚至有益。所有农村儿童都需要持续的营养支持，特别是预防微量营养素缺乏的干预措施。建议留守儿童项目继续关注营养问题，但也要更加关注其他重要的健康问题。
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