北京某社区8月龄婴儿保健现况调查
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摘要
目的调查所研究地区常住和流动8月龄婴儿的喂养及健康现状,掌握儿童保健相关指标,为进一步做好基层儿童保健工作提供指导依据。方法采用横断面研究方法,选取2014年在北京某社区接受常规儿童保健,并排除早产、低出生体重、先天缺陷,以及心、肝、肾、血液系统疾病所有8月龄婴儿496名为研究对象,通过问卷调查和现场测量收集婴儿信息进行统计分析。结果所调查地区常住和流动人口婴儿早开奶率分别为39.1%和21.9%(χ~2=14.935,P<0.05),6月龄内纯母乳喂养率分别为36.7%和27.2%(χ~2=4.495,P<0.05),6月龄内辅食添加率分别为48.9%和65.1%(χ~2=11.729,P<0.05),辅食添加平均月龄分别为(5.42±0.79)和(5.22±0.92)(t=2.521,P<0.05)。喂养指数得分均值和合格率常住者(12.43±2.23,69.4%)均大于流动者(11.41±2.18,52.1%),t=4.873,χ~2=14.469,均P<0.01。腹泻2周患病率常住婴儿(5.20%)小于流动婴儿(10.10%),χ~2=4.122,P<0.05。常住婴儿年龄别身长Z评分(LAZ)、年龄别头围Z评分(HCZ)和血红蛋白均值均大于流动婴儿(t值分别为4.393、3.971、5.309,均P<0.01),常住婴儿低体重率和贫血患病率均少于流动婴儿(确切概率法P=0.009;χ~2=19.418,P<0.01),消瘦、生长迟缓、超重(肥胖)率两者间差异均无统计学意义(均P>0.05)。常住婴儿母亲喂养知识和态度均好于流动婴儿母亲,在知识获取途径中,产前保健利用均较低。结论所调查地区8月龄婴儿喂养和健康状况常住者好于流动者,但总体不容乐观;流动婴儿母亲喂养知识和态度亟需改善。
Objective To investigate the feeding practice and health of infants aged 8 months in resident and migrant population and master relevant indicators of health care,so as to provide guidance for further improvement of primary child health care.Methods A cross-sectional study was conducted.Infants aged 8 months accepting conventional community child health services in Beijing in2014 were selected,excluding those of premature birth,low birth weight and with congenital birth defects and heart,liver,kidney,blood diseases.Questionnaire and field measurement on infant information were investigated and analyzed.Results In resident infants and migrant infants,the early initiation of breastfeeding was 39.1%and 21.9%(χ~2=14.935,P<0.05),exclusive breastfeeding rate under 6 months was 36.7%and 27.2%(χ~2=4.495,P<0.05),complementary feeding rate before 6 months was48.9% and 65.1%(χ~2=11.729,P<0.05),the average age of month of complementary feeding was 5.42±0.794 and 5.22±0.916(t=2.521,P<0.05).The mean value and qualified rate of feeding index of the resident infants(12.43±2.23,69.4%)were better than the migrant infants(11.41±2.18,52.1%)(t=4.873,χ~2=14.469,P<0.01).Prevalence of two-week diarrhea was higher in migrant(10.10%)than in resident infants(5.20%)(χ~2=4.122,P<0.05).Mean of length for age Z-score(LAZ),height for head circumference Z-score(HCZ)and hemoglobin were higher in resident infants than in migrant infants(t value was 4.393,3.971 and 5.309,respectively,all P<0.01).The rate of underweight and the prevalence of anemia was lower in resident infants than in migrant infants(exact propability P =0.009;χ~2=19.418,P <0.01).But there was no significant difference in incidence of emaciation,growth retardation,and overweight and obesity(all P >0.05).The mothers' feeding knowledge and attitude in resident population were better than the migrants,but in the ways acquiring knowledge,the utilization of prenatal care was low in both cases.Conclusion The feeding practice and health of infants aged 8 months in resident population are better than the migrants,but overall condition is not optimistic.The mother's feeding knowledge and attitude in migrants need to be improved.
Objective To investigate the feeding practice and health of infants aged 8 months in resident and migrant population and master relevant indicators of health care,so as to provide guidance for further improvement of primary child health care.Methods A cross-sectional study was conducted.Infants aged 8 months accepting conventional community child health services in Beijing in2014 were selected,excluding those of premature birth,low birth weight and with congenital birth defects and heart,liver,kidney,blood diseases.Questionnaire and field measurement on infant information were investigated and analyzed.Results In resident infants and migrant infants,the early initiation of breastfeeding was 39.1%and 21.9%(χ~2=14.935,P<0.05),exclusive breastfeeding rate under 6 months was 36.7%and 27.2%(χ~2=4.495,P<0.05),complementary feeding rate before 6 months was48.9% and 65.1%(χ~2=11.729,P<0.05),the average age of month of complementary feeding was 5.42±0.794 and 5.22±0.916(t=2.521,P<0.05).The mean value and qualified rate of feeding index of the resident infants(12.43±2.23,69.4%)were better than the migrant infants(11.41±2.18,52.1%)(t=4.873,χ~2=14.469,P<0.01).Prevalence of two-week diarrhea was higher in migrant(10.10%)than in resident infants(5.20%)(χ~2=4.122,P<0.05).Mean of length for age Z-score(LAZ),height for head circumference Z-score(HCZ)and hemoglobin were higher in resident infants than in migrant infants(t value was 4.393,3.971 and 5.309,respectively,all P<0.01).The rate of underweight and the prevalence of anemia was lower in resident infants than in migrant infants(exact propability P =0.009;χ~2=19.418,P <0.01).But there was no significant difference in incidence of emaciation,growth retardation,and overweight and obesity(all P >0.05).The mothers' feeding knowledge and attitude in resident population were better than the migrants,but in the ways acquiring knowledge,the utilization of prenatal care was low in both cases.Conclusion The feeding practice and health of infants aged 8 months in resident population are better than the migrants,but overall condition is not optimistic.The mother's feeding knowledge and attitude in migrants need to be improved.
引文
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[13]刘晓梅,段英梅,马运苗,等.178名独生子女产妇母乳喂养知识、态度及行为调查[J].中国妇幼健康研究,2016,27(9):1107-1110.
[14]王建英,曹建用,石少权.家属参与孕期健康教育对母乳喂养的影响[J].中华全科医学,2010,8(7):892-893.
[15]Leahy-Warren P,Mccarthy G,Corcoran P.First-time mothers:social support,maternal parental self-efficacy and postnatal depression[J].J Clin Nurs,2012,21(3-4):388-397.
[16]Herrmann G,Woermann U,Schlegel C.Interprofessional education in anatomy:Learning together in medical and nursing training[J].Anat Sci Educ,2015,8(4):324-330.
[17]林环环,蔡彩萍.孕产期教育对母乳喂养影响的观察[J].护理研究,2011,25(26):2406.
[18]王桂丽.产后母乳喂养成功实施的影响因素及对策[J].中国城乡企业卫生,2013,(1):121-123.
[19]杨琳,王彩凤.婴幼儿母亲对母乳喂养的认知及影响因素调查[J].解放军护理杂志,2015,32(20):23-27.
[2]Rgobert E,Catherine E W.Iron deficiency anemia:recommended guidelines for the prevention,detection,and management among U.S.children and women of childbearing age[M].Washington DC:National Academies Press,1993:4.
[3]Marie T R,Purnima M.Child feeding practices are associated with child nutritional status in Latin America:innovative uses of the demographic and health surveys[J].J Nutr,2002,132(6):1180-1187.
[4]应艳红,潘建平,黄建玲,等.汉中市婴幼儿喂养指数与体格发育的相关性研究[J].中国妇幼健康研究,2017,28(1):12-15.
[5]彭敏,曾果,赖建强,等.应用喂养指数法评价成都市6~24月龄婴幼儿喂养行为[J].中华预防医学杂志,2010,44(6):505-509.
[6]Zhang J,Shi L,Wang J,et al.An infant and child feeding index is associated with child nutritional status in rural China[J].Early Hum Dev,2009,85(4):247-252.
[7]赖建强,荫士安,马冠生,等.6~24月龄婴幼儿喂养指数分别以及生长发育的相关性研究[J].卫生研究,2005,34(5):617-619.
[8]WHO/UNICEF/IFPRI/UCDAVIS/FANTA/AED/U-SAID.Indicators for assessing infant and young child feeding practices part3:Country profiles[R].Geneva:WHO,2010:43-45.
[9]闫淑娟,陈欣欣,段建华,等.北京市5岁以下流动儿童保健状况与需求分析[J].中国儿童保健杂志,2008,16(5):542-543,545.
[10]WHO.儿童:降低死亡率(实况报道,第178号2013)[EB/OL].[2018-04-23].http://www.who.int/mediacentre/factsheets/fs178/zh/.
[11]中华人民共和国卫生部.中国0~6岁儿童营养发展报告[R].北京:中华人民共和国卫生部,2012.
[12]张悦,王惠珊,姚礼明.我国城市产妇母乳喂养知识、态度与喂养行为的关联研究[J].中国健康教育,2012,28(5):363-366.
[13]刘晓梅,段英梅,马运苗,等.178名独生子女产妇母乳喂养知识、态度及行为调查[J].中国妇幼健康研究,2016,27(9):1107-1110.
[14]王建英,曹建用,石少权.家属参与孕期健康教育对母乳喂养的影响[J].中华全科医学,2010,8(7):892-893.
[15]Leahy-Warren P,Mccarthy G,Corcoran P.First-time mothers:social support,maternal parental self-efficacy and postnatal depression[J].J Clin Nurs,2012,21(3-4):388-397.
[16]Herrmann G,Woermann U,Schlegel C.Interprofessional education in anatomy:Learning together in medical and nursing training[J].Anat Sci Educ,2015,8(4):324-330.
[17]林环环,蔡彩萍.孕产期教育对母乳喂养影响的观察[J].护理研究,2011,25(26):2406.
[18]王桂丽.产后母乳喂养成功实施的影响因素及对策[J].中国城乡企业卫生,2013,(1):121-123.
[19]杨琳,王彩凤.婴幼儿母亲对母乳喂养的认知及影响因素调查[J].解放军护理杂志,2015,32(20):23-27.