National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
School of Public Health, Peking University, Haidian District, Beijing 100191, China.
BMJ. 2024 Oct 28;387:e079499. doi: 10.1136/bmj-2024-079499.
To assess trends and differences in child malnutrition by population subgroups among infants aged 6-23 months in China's poorest rural counties.
Six consecutive cross sectional surveys were conducted annually.
The study was conducted in 116 counties in 19 provinces from 2016 to 2021, representing China's 832 poorest counties.
A total of 210 088 participants were selected through a multistage cluster sampling procedure; all participants were infants aged 6-23 months.
Prevalence of anaemia, stunting, wasting, overweight, and growth status in children (measured by length-for-age and weight-for-length z scores).
Four main malnutrition forms were prevalent in 2016: anaemia (prevalence 18.3%), stunting (7.5%), wasting (4.7%), and overweight (3.1%). The prevalence of any two coexisting malnutrition forms was low. All four forms of malnutrition decreased from 2016 to 2021. Anaemia decreased by more than half, with an annual reduction rate of 9.11% (95% confidence interval (CI) 4.83% to 13.20%). Stunting was reduced by over a third, with an annual reduction rate of 10.44% (7.56% to 13.22%), which is faster than the World Health Organization's target of 3.9%. Differences in child growth by county gross domestic product quarters were small and decreased over time, but growth differences related to education persisted. Infants whose mothers completed education up to primary school level had approximately twice the risk of stunting (adjusted rate ratio 2.29 (95% CI 1.87 to 2.81)) and wasting (1.73 (1.40 to 2.13)) compared with children whose mothers had an education level of a college degree or above. Boys had poorer growth and higher anaemia than did girls. For all outcomes, differences related to sex and education were greatest at 6 months of age.
Education related inequalities in growth of infants persists, with these differences particularly affecting children whose mothers completed education only up to primary school level.
评估中国最贫困农村县 6-23 月龄婴儿的人口亚组儿童营养不良的趋势和差异。
连续六年进行了六次横断面调查。
这项研究于 2016 年至 2021 年在 19 个省的 116 个县进行，代表了中国 832 个最贫困的县。
通过多阶段聚类抽样程序选择了 210088 名参与者；所有参与者均为 6-23 月龄的婴儿。
贫血、发育迟缓、消瘦、超重和儿童生长状况（通过年龄和长度的 z 评分来衡量）的流行率。
2016 年有四种主要的营养不良形式普遍存在：贫血（流行率 18.3%）、发育迟缓（7.5%）、消瘦（4.7%）和超重（3.1%）。同时存在两种共存营养不良形式的情况很少见。所有四种形式的营养不良都从 2016 年到 2021 年减少。贫血减少了一半以上，年减少率为 9.11%（95%置信区间 4.83%至 13.20%）。发育迟缓减少了三分之一以上，年减少率为 10.44%（7.56%至 13.22%），快于世界卫生组织的 3.9%的目标。县国内生产总值季度儿童生长差异较小且随时间减少，但与教育相关的生长差异持续存在。母亲仅完成小学教育的婴儿发育迟缓的风险大约是母亲具有大学学位或以上教育水平的婴儿的两倍（调整后的率比 2.29（95%置信区间 1.87 至 2.81））和消瘦（1.73（1.40 至 2.13））。与女孩相比，男孩的生长情况较差且贫血率更高。对于所有结果，性别和教育相关的差异在 6 个月时最大。
与生长相关的婴儿教育不平等仍然存在，这些差异尤其影响母亲仅完成小学教育的儿童。
