文章摘要
张业武,陶芳标,尹惠萍,朱晓明,计国平,孔圣华,宋清华,陈建华,储诚志,李竹.安徽省2周岁内母乳与非母乳喂养儿童血清维生素A水平比较分析[J].中华流行病学杂志,2006,27(4):302-306
安徽省2周岁内母乳与非母乳喂养儿童血清维生素A水平比较分析
Differences in serum retinol level between the breastfed and non-breastfed children aged 0 to 23 months
收稿日期:2005-05-23  出版日期:2014-09-18
DOI:
中文关键词: 母乳喂养  维生素A缺乏  辅食添加
英文关键词: Breastfeeding  Vitamin A deficiency  Complementary foods supplementations
基金项目:
作者单位
张业武 100083, 北京大学生育健康研究所 
陶芳标 安徽省医科大学儿少卫生和妇幼卫生系 
尹惠萍 安徽省妇幼保健所 
朱晓明 安徽省妇幼保健所 
计国平 安徽省妇幼保健所 
孔圣华 安徽省妇幼保健所 
宋清华 安徽省妇幼保健所 
陈建华 安徽省妇幼保健所 
储诚志 安徽省妇幼保健所 
李竹 100083, 北京大学生育健康研究所 
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中文摘要:
      目的了解母乳与非母乳喂养儿童中血清维生素A水平是否存在差异以及造成差异可能原因。方法研究数据来自人群为基础的儿童维生素A营养状况横断面调查,共调查401名 0-23月龄儿童。采用改良的荧光方法测定血清中视黄醇含量来反映维生素A水平,通过问卷方法调查儿童的家庭社会经济、围产期保健、2周内患病情况;半定量膳食频率问卷调查前1周内儿童膳食情况。利用SAS 8.1软件进行统计分析。结果 401名2岁内儿童中,母乳喂养率为50.37%;非母乳喂养组维生素A平均水平为(30.67±0.57)μg/dl,母乳喂养组为(27.60±0.56)μg/dl,两组差异有统计学意义(P<0.01);在控制其他因素影响后,调整后的非母乳喂养组均值为(31.82±0.98)μg/dl, 母乳喂养组为(29.46±0.96)μg/dl,差异有统计学意义(P<0.01)。按年龄组分层分析显示,0月龄~、6月龄~、12月龄~和18月龄~组的母乳喂养率分别92.1%、70.1%、32.0%和17.1%。各年龄组内两组间(非母乳喂养组-母乳喂养组)维生素A均值差值及其95%可信区间(CI)分别为4.70 (-2.52-1.92)、0.82(-2.32-3.95)、2.95(-0.68-6.58)和6.05(2.34-9.77)μg/dl;控制其他混杂因素后,调整后的两组均值差值及其95%CI分别为0.00(-7.18-7.19)、1.35(-1.76-4.45)、 2.92(-0.82-6.65)和4.26(0.71-7.81)μg/dl;调整前、后只有18月龄组非母乳喂养组和母乳喂养组维生素A水平差异有统计学意义(P<0.01)。趋势x2检验表明12月龄以后母乳喂养儿童辅食添加频率均比非母乳喂养儿童低。结论与非母乳喂养儿童相比,母乳喂养儿童的体内维生素A水平有所降低,但差别只是局限在18月龄以后儿童中。母乳中维生素A含量不足以及辅食添加不充分可能是造成这种差异潜在原因。控制人群中维生素A缺乏应该采取综合干预措施。
英文摘要:
      Objective Some recent studies found that high prevalence of vitamin A deficiency in the breastfed children. This study aimed to understand the differences in serum retinol level between breastfed and bottle-fed children aged 0 to 23 months and the possible causes of low level of serum retinol for the breastfed children. Methods Data for children aged 0 to 23 months were extracted from a population-based cross sectional study for vitamin A nutrition status. Fluorescence method was used to measure the serum retinol. Mothers or caregivers were asked to answer a pre-designed questionnaire and socioeconomic status, peri-natal care, breastfeeding status, morbidity histories and other related factors were collected. Semi-quantitative food frequency questionnaire was used to investigate the child's dietary intake one week prior to the survey. Data were analyzed using SAS 8. 1. Results Of 401 children aged 0 to 23 months, the breastfeeding rate was 50.37% . The means of the serum retinol level between bottle-fed (30.67±0.57) μg/dl and the breastfed children (27.60±0.56)μg/dl was significantly different(P<0.01). The corresponding figures were (31.82±0.98)μg/dl and (29.46±0.96)μg/dl after adjustment for confounders, which also showed significant difference (P<0.01). After stratified by age groups, the breastfeeding rates in the 0~, 6~, 12~ and 18~months groups were 92.1%, 70.1%, 32.0% and 17.1%, respectively. We calculated the difference in means of the serum retinol level between the bottle-fed and breastfed children for each of four age groups, and the 95% confidence limits of the differences. The differences in means and the 95 % confidence limits for 0~, 6~, 12~ and 18~months group were 4.70 μg/dl (-2.52~1.92),0.82 μg/dl(-2.32~3.95), 2.95 μg/dl (-0.68~6.58) and 6.05 μg/dl (2.34~9.77), respectively. After adjustment for confounders and covariates,the adjusted figures were 0.00 μg/dl(-7.18~7.19),1.35 μg/dl(-1.76~4.45),2.92 μg/dl(-0.82~6.65) and 4.26 μg/dl(0.71~7.81),respectively. The significant difference in means of serum retinol level was only found in the 18~months group before or after adjustments (P0.01 for both). The Cochrane-Atmitage chi square trend test showed that the breastfed children tended to have lower frequencies of complementary dietary intakes than that of the bottle-fed aged 12 months and above. Conclusions The breastfed children aged 0 to 23 months had relative low serum retinol level while compared with the bottle-fed. However, the significant differences seemed to be only confined to those aged 18 months and above. Low level of vitamin A in breast milk and low frequent complimentary food supplements might have served as the potential for the differences.
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