Harvard T. H. Chan School of Public Health, Department of Global Health and Population, Boston, United States; Universidade Federal do Ceará, Departamento de Saúde Materno-Infantil, Fortaleza, CE, Brazil; Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, CE, Brazil.
Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, CE, Brazil.
J Pediatr (Rio J). 2022 May-Jun;98(3):316-322. doi: 10.1016/j.jped.2021.07.003. Epub 2021 Sep 9.
To explore the relationship of undernutrition and the short duration of breastfeeding with child development of children 0-66 months of age residing in Ceará, Brazil.
The authors of the present study utilized population-based data from children enrolled in the Study on Maternal and Child Health in Ceará, Brazil (PESMIC). Children's development was assessed with the Ages and Stages Questionnaire third version, validated in Brazil. Undernutrition was accessed through anthropometric measures obtained by trained staff. Breastfeeding information was obtained through the mothers' report and confirmed in the child's governmental booklet. The authors used logistic regressions adjusted for sample clusters used in PESMIC design in a theoretical model for known determinants of child development following the World Health Organization nurturing framework.
A total of 3,566 children were enrolled in the sixth PESMIC study and had their development assessed. The authors found that 8.2%, 3.0%, 2.1%, and 3.6% of children were stunted, underweight, or wasted, at the time of the interview, respectively. All studied factors were associated with a higher prevalence of child development impairment in at least one of the assessed domains. Underweight was the factor with the strongest effect, with an adjusted odds ratio (AOR) of 4,14 (2,26-7,58), p < 0.001. Breastfeeding for up to two months compared to more than six months (AOR 2,08 (1,38-3,12)) was also associated.
The authors found that undernutrition and short duration of breastfeeding are associated with development outcomes among Brazilian children. As a result, integrated nutritional programs may improve child development outcomes.
探讨巴西塞阿拉州 0-66 月龄儿童营养不足和母乳喂养时间过短与儿童发育的关系。
本研究的作者使用了巴西塞阿拉州母婴健康研究（PESMIC）中的基于人群的数据。儿童的发育通过经过验证的巴西版年龄与阶段问卷第三版进行评估。通过训练有素的工作人员获得的人体测量学指标评估营养不足。母乳喂养信息通过母亲报告获得，并在孩子的政府手册中得到确认。作者使用了在 PESMIC 设计中使用的样本聚类进行调整的逻辑回归，在世界卫生组织养育框架下，建立了一个已知儿童发育决定因素的理论模型。
共有 3566 名儿童参加了第六次 PESMIC 研究，并对其发育情况进行了评估。作者发现，分别有 8.2%、3.0%、2.1%和 3.6%的儿童在访谈时存在发育迟缓、体重不足或消瘦。所有研究因素均与至少一个评估领域的儿童发育受损的更高患病率相关。体重不足是影响最大的因素，调整后的优势比（AOR）为 4.14（2.26-7.58），p<0.001。与母乳喂养超过 6 个月相比，母乳喂养持续时间长达 2 个月（AOR 2.08（1.38-3.12））也与发育受损相关。
作者发现，营养不足和母乳喂养时间过短与巴西儿童的发育结果有关。因此，综合营养计划可能会改善儿童的发育结果。
