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代际关联:巴西亚马孙地区雅诺马米土著儿童中母亲身材矮小与发育迟缓的关系。

Intergenerational Association of Short Maternal Stature with Stunting in Yanomami Indigenous Children from the Brazilian Amazon.

机构信息

Leônidas e Maria Deane Institute, Oswaldo Cruz Foundation, Rua Teresina, 476, Adrianópolis, Manaus 69057-070, Brazil.

Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° Piso, Centro, Pelotas 96020-220, Brazil.

出版信息

Int J Environ Res Public Health. 2021 Aug 30;18(17):9130. doi: 10.3390/ijerph18179130.

Abstract

To describe the factors associated to stunting in <5-year-old Yanomami Brazilian children, and to evaluate the association of short maternal stature to their offspring's stunting. A cross-sectional study carried out in three villages in the Yanomami territory. We performed a census, in which all households with children < 5-years-old were included. The length/height-for-age z-score <-2 standard deviations was used to classify the children as stunted. Short maternal height was defined as <145 cm for adult women, and <-2 standard deviations of the height-for-age z-score for adolescent women. We used adjusted Poisson regression models to estimate prevalence ratios (PR) along the 90% confidence interval. We evaluated 298 children. 81.2% of children suffered from stunting and 71.9% of the mothers from short stature. In the bivariate analysis, a significant association of stunting with short maternal stature, gestational malaria and child's place of birth were observed. Considering the variables of the children under five years of age, there were significant associations with age group, the child's caregiver, history of malaria, pneumonia, and malnutrition treatment. In the adjusted hierarchical model, stunting was 1.22 times greater in the offspring of women with a short stature (90% CI: 1.07-1.38) compared to their counterparts. Brazilian Amazonian indigenous children living in a remote area displayed an alarming prevalence of stunting, and this was associated with short maternal height, reinforcing the hypothesis of intergenerational chronic malnutrition transmission in this population. In addition, children above 24 months of age, who were born in the village healthcare units and who had had previous treatment in the past for stunting presented higher rates of stunting in this study.

摘要

描述与巴西雅诺马米 5 岁以下儿童矮小症相关的因素,并评估矮小母亲与子女矮小症的关联。这是在雅诺马米地区的三个村庄进行的横断面研究。我们进行了一次普查,将所有有<5 岁儿童的家庭都包括在内。使用长度/身高年龄 z 分数<-2 个标准差来将儿童归类为矮小症。矮小的母亲身高定义为成年女性<145 厘米,青少年女性的身高年龄 z 分数<-2 个标准差。我们使用调整后的泊松回归模型来估计患病率比(PR)及其 90%置信区间。我们评估了 298 名儿童。81.2%的儿童患有矮小症,71.9%的母亲身材矮小。在单因素分析中,观察到矮小症与矮小母亲、妊娠疟疾和儿童出生地之间存在显著关联。考虑到五岁以下儿童的变量,与年龄组、儿童照顾者、疟疾史、肺炎史和营养不良治疗史存在显著关联。在调整后的分层模型中,与身材正常的母亲相比,身材矮小的母亲的子女矮小症患病风险增加 1.22 倍(90%CI:1.07-1.38)。生活在偏远地区的巴西亚马逊土著儿童矮小症的流行率令人震惊,这与矮小母亲身高有关,这强化了该人群中代际慢性营养不良传播的假说。此外,在本研究中,年龄在 24 个月以上、在村卫生保健单位出生和过去曾因矮小症接受过治疗的儿童,矮小症的发生率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88a9/8430951/68ba9a9835e9/ijerph-18-09130-g001.jpg

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