Association Between Breastfeeding and Child Stunting in Mexico.
Association Between Breastfeeding and Child Stunting in Mexico.
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DOI：
10.5334/aogh.2836
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发表时间：
2020-11-17
影响因子：
2.9
通讯作者：
Hawkins SS
中科院分区：
文献类型：
--
作者：
Campos AP;Vilar-Compte M;Hawkins SS
在全球范围内，儿童发育迟缓的流行率在过去几十年里一直在下降。然而，在墨西哥等低收入和中等收入国家，发育迟缓仍然是最普遍的营养不良形式，影响到大量处于最脆弱状况的儿童。母乳喂养已被确定为防止儿童发育迟缓的关键的负担得起和可修改的孕产妇健康行为之一。检查母乳喂养(定义为从未母乳喂养、6个月母乳喂养和≥6个月母乳喂养)和其他个人、家庭和地区因素与墨西哥儿童发育迟缓(定义为性别身高/身高z分数低于世界卫生组织儿童生长标准中值2标准差)之间的联系。利用2012年墨西哥健康和营养调查进行的二级数据分析，该调查使国家一级的农村和城市地区以及墨西哥4个地区具有代表性。我们的子集包括2,089名6-35个月的墨西哥独生子女的数据，以及先前确定的发育迟缓的风险和保护因素的信息。我们进行了固定效应和混合效应的Logistic回归模型，对每个水平的因素进行了顺序控制。总体而言，12.3%的儿童发育迟缓，71.1%的儿童接受母乳喂养6个月≥。在所有模特中，任何母乳喂养和女性身份都是防止儿童发育迟缓的始终如一的保护因素。相比之下，在所有模型中，儿童出生体重低、母亲身材矮小、每户5岁儿童数量较多、以及中度到严重的食物不安全都是儿童发育迟缓的一致危险因素。根据我们的发现，减少墨西哥儿童发育迟缓的努力应该包括产前战略，旨在防止出生体重过低的子女，特别是在身材矮小的妇女、中度到严重的食物不安全家庭、5岁儿童数量较多的家庭以及土著社区。出生后的组成部分应包括支持母乳喂养的多层次战略。
Globally, the prevalence of child stunting has been decreasing over the past decades. However, in low- and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. To examine the association between breastfeeding (defined as never breastfed, any breastfeeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed- and mixed-effects logistic regression models sequentially controlling for each level of factors. Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breastfeeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.
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影响因子：
168.9
作者：
Adair, Linda S.;Fall, Caroline H. D.;Osmond, Clive;Stein, Aryeh D.;Martorell, Reynaldo;Ramirez-Zea, Manuel;Sachdev, Harshpal Singh;Dahly, Darren L.;Bas, Isabelita;Norris, Shane A.;Micklesfield, Lisa;Hallal, Pedro;Victora, Cesar G.
通讯作者：
Victora, Cesar G.
影响因子：
3.5
作者：
Gillespie, Brenda;d'Arcy, Hannah;Foxman, Betsy
通讯作者：
Foxman, Betsy
影响因子：
168.9
作者：
Black, Robert E.;Victora, Cesar G.;Uauy, Ricardo
通讯作者：
Uauy, Ricardo
DOI：
10.1111/apa.13102
发表时间：
2015-12
期刊：
Acta paediatrica (Oslo, Norway : 1992)
影响因子：
--
作者：
Chowdhury R;Sinha B;Sankar MJ;Taneja S;Bhandari N;Rollins N;Bahl R;Martines J
通讯作者：
Martines J
影响因子：
120.7
作者：
Ozaltin, Emre;Hill, Kenneth;Subramanian, S. V.
通讯作者：
Subramanian, S. V.