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首页> 外文期刊>Sao Paulo Medical Journal >Determinants of impaired growth among hospitalized children: a case-control study
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Determinants of impaired growth among hospitalized children: a case-control study

机译：住院儿童生长受损的决定因素：病例对照研究

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CONTEXT: Protein energy malnutrition constitutes a public health problem, especially in less affluent countries. The identification of amenable predictive risk factors is of major importance for policy makers to plan interventions to reduce infant malnutrition. OBJECTIVE: To identify risk factors for protein energy malnutrition among hospitalized low-income children aged 6 to 24 months. TYPE OF STUDY: Case-control study. SETTING: Two public hospitals in Recife, Brazil. PARTICIPANTS: The cases were 124 infants with length-for-age below the 10th percentile of the National Center for Health Statistics curve and the controls were 241 infants with length-for-age equal to or above the 10th percentile who were recruited in the same infirmary. METHODS: Cases and controls were compared in relation to a variety of sociodemographic, environmental and reproductive factors, and their healthcare, previous feeding practice and morbidity. Logistic regression analysis was used to investigate the net effect of risk factors on infant malnutrition, after adjusting for potential confounding variables. RESULTS: The mother's age, possession of a TV set, type of water supply, family size and location of the home were significantly associated with child malnutrition in the bivariate analysis. However, these associations lost their significance after adjusting for other explanatory variables in the hierarchical logistic regression analysis. This analysis showed that low birth weight contributed the largest risk for impaired growth. Increased risks of infant malnutrition were also significantly associated with households that had no toilet facilities or refrigerator, high parity for the mother, no breastfeeding of the infant, inadequate vaccination coverage and previous hospitalization for diarrhea and pneumonia. DISCUSSION: The literature shows that chronic malnutrition, as assessed by low length-for-age indexes, is often related to low income. However, this was not the case in this study, in which other variables had greater impact on child growth. CONCLUSIONS: In view of the multiple causes of malnutrition, the interrelationship among its determinants should be taken into account when adopting strategies for its reduction and prevention.
机译：背景：蛋白质能量营养不良构成公共卫生问题，尤其是在富裕国家中。对于政策制定者来说，确定适当的预测性危险因素对于计划减少婴儿营养不良的干预措施至关重要。目的：确定住院6至24个月的低收入儿童蛋白质能量营养不良的危险因素。研究类型：病例对照研究。地点：巴西累西腓的两家公立医院。参加者：124例年龄在国家卫生统计中心曲线第10个百分位以下的婴儿，对照组为241名年龄在10％或以上的婴儿医务室。方法：对病例和对照进行了比较，涉及各种社会人口统计学，环境和生殖因素及其保健，以前的喂养习惯和发病率。校正潜在的混杂变量后，使用逻辑回归分析研究风险因素对婴儿营养不良的净影响。结果：在双因素分析中，母亲的年龄，拥有电视机，供水类型，家庭规模和家庭位置与儿童营养不良密切相关。但是，在调整了层次逻辑回归分析中的其他解释变量之后，这些关联失去了意义。这项分析表明，低出生体重是造成发育障碍的最大风险。婴儿营养不良的风险增加也与没有厕所或冰箱，母亲的均等性高，婴儿没有母乳喂养，疫苗接种覆盖率不足以及以前因腹泻和肺炎而住院的家庭密切相关。讨论：文献表明，按年龄低的年龄指数评估，慢性营养不良通常与低收入有关。但是，本研究并非如此，在该研究中，其他变量对儿童成长有更大的影响。结论：鉴于营养不良的多种原因，在采取减少和预防策略时应考虑其决定因素之间的相互关系。

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