黎巴嫩生命最初 1000 天期间营养状况的决定因素：儿童的性别很重要。

Determinants of nutritional status during the first 1000 days of life in Lebanon: Sex of the child matters.

机构信息

Department of Nutrition Science, Purdue University, West Lafayette, IN, USA.

Department of Nutrition and Food Science, American University of Beirut, Beirut, Lebanon.

出版信息

Paediatr Perinat Epidemiol. 2021 Jul;35(4):501-510. doi: 10.1111/ppe.12747. Epub 2021 Jan 11.

DOI:10.1111/ppe.12747

PMID:33428236

Abstract

BACKGROUND

The first 1000 days of life support child growth and long-term health, but few studies address this period in Lebanon and the Eastern Mediterranean Region.

OBJECTIVE

To examine the determinants of nutritional status among Lebanese children ≤2 years old by child's sex.

METHODS

We analysed data from a nationally representative cross-sectional survey of 466 mother-child dyads. We classified socio-economic, maternal, and child characteristics using a hierarchical conceptual framework into distal, intermediate, and proximal levels, respectively. Sex-stratified weighted multiple linear regression was computed to identify the determinants of length-for-age z-scores (LAZ) and weight-for-length z-scores (WLZ).

RESULTS

The mean (standard deviation) of LAZ and WLZ was -0.3 (1.6) and 0.5 (1.5) among boys and -0.1 (1.4) and 0.5 (1.0) among girls, respectively. At the distal level, maternal intermediate or high school education was associated with higher boys' LAZ (β 1.0, 95% confidence interval (CI) 0.2, 1.8), and less crowded households were associated with higher girls' LAZ (β 0.8, 95% CI 0.3, 1.4). At the intermediate level, maternal obesity was associated with lower girls' LAZ (β -0.9, 95% CI -1.4, -0.4). At the proximal level, birth length directly (β 0.1, 95% CI 0.0, 0.2) and breast-feeding duration inversely (β -0.1, 95% CI -0.1, -0.0) associated with girls' LAZ. For WLZ, paternal attainment of university degree or technical diploma was associated with lower boys' WLZ (β -0.9, 95% CI -1.8, -0.1). Among the proximal determinants, birthweight was directly associated with boys' WLZ (β 1.2, 95% CI 0.6, 1.8), while being a third or later child was associated with lower girls' WLZ (β -0.5, 95% CI -0.8, -0.2). Child age was directly associated with WLZ among boys and girls (β 0.1, 95% CI 0.0, 0.1).

CONCLUSIONS

Nutritional status determinants differed by child's sex in Lebanon. These findings may help inform interventions to improve child growth.

摘要

背景

生命的头 1000 天支持儿童生长和长期健康，但很少有研究关注黎巴嫩和东地中海区域的这一时期。

目的

按儿童性别研究黎巴嫩≤2 岁儿童的营养状况决定因素。

方法

我们分析了来自全国代表性的 466 对母婴对子的横断面调查数据。我们使用分层概念框架将社会经济、孕产妇和儿童特征分别归类为远端、中间和近端水平。按性别分层加权多元线性回归用于确定年龄别身长 z 评分（LAZ）和身长别体重 z 评分（WLZ）的决定因素。

结果

男孩的 LAZ 和 WLZ 的平均值（标准差）分别为-0.3（1.6）和 0.5（1.5），女孩的分别为-0.1（1.4）和 0.5（1.0）。在远端水平，母亲中等或高等教育与男孩的较高 LAZ 相关（β 1.0，95%置信区间（CI）0.2，1.8），而较少拥挤的家庭与女孩的较高 LAZ 相关（β 0.8，95%CI 0.3，1.4）。在中间水平，母亲肥胖与女孩的较低 LAZ 相关（β-0.9，95%CI-1.4，-0.4）。在近端水平，出生长度直接（β 0.1，95%CI 0.0，0.2）和母乳喂养持续时间间接（β-0.1，95%CI-0.1，-0.0）与女孩的 LAZ 相关。对于 WLZ，父亲获得大学学位或技术文凭与男孩的 WLZ 较低相关（β-0.9，95%CI-1.8，-0.1）。在近端决定因素中，出生体重与男孩的 WLZ 直接相关（β 1.2，95%CI 0.6，1.8），而作为第三个或更多的孩子与女孩的 WLZ 较低相关（β-0.5，95%CI-0.8，-0.2）。儿童年龄与男孩和女孩的 WLZ 直接相关（β 0.1，95%CI 0.0，0.1）。