Adair L S, Guilkey D K
Carolina Population Center, University of North Carolina at Chapel Hill, 27516, USA.
J Nutr. 1997 Feb;127(2):314-20. doi: 10.1093/jn/127.2.314.
This study identifies age-specific factors related to new cases of stunting that develop in Filipino children from birth to 24 mo of age. Data come from nearly 3000 participants in the Cebu Longitudinal Health and Nutrition Survey, a community-based study conducted from 1983 to 1995. Length, morbidity, feeding and health-related data were collected bimonthly during home visits. Stunting (length >2 SD below the WHO age- and sex-specific medians) occurred in 69% of rural and 60% of urban children by 24 mo of age. We used a multivariate discrete time hazard model to estimate the likelihood of becoming stunted in each 2-mo interval. The likelihood of stunting was significantly increased by diarrhea, febrile respiratory infections, early supplemental feeding and low birth weight. The effect of birth weight was strongest in the first year. Breast-feeding, preventive health care and taller maternal stature significantly decreased the likelihood of stunting. Males were more likely to become stunted in the first year, whereas females were more likely to become stunted in the second year of life. Because stunting is strongly related to poor functional outcomes such as impaired intellectual development during childhood, and to short stature in adulthood, these results emphasize the need for prevention of growth retardation through promotion of prenatal care and breast-feeding, as well as control of infectious diseases.
本研究确定了菲律宾儿童从出生到24月龄期间与发育迟缓新病例相关的特定年龄因素。数据来自宿务纵向健康与营养调查的近3000名参与者，这是一项于1983年至1995年开展的基于社区的研究。在家庭访视期间每两个月收集一次身长、发病率、喂养及健康相关数据。到24月龄时，69%的农村儿童和60%的城市儿童出现发育迟缓（身长低于世界卫生组织年龄和性别特异性中位数2个标准差以上）。我们使用多变量离散时间风险模型来估计每两个月期间发育迟缓的可能性。腹泻、发热性呼吸道感染、过早添加辅食和低出生体重显著增加了发育迟缓的可能性。出生体重的影响在第一年最为明显。母乳喂养、预防性保健和较高的母亲身高显著降低了发育迟缓的可能性。男性在第一年更易出现发育迟缓，而女性在生命的第二年更易出现发育迟缓。由于发育迟缓与儿童期智力发育受损等不良功能结局以及成年期身材矮小密切相关，这些结果强调了通过促进产前保健和母乳喂养以及控制传染病来预防生长发育迟缓的必要性。
