Factors associated with the nutritional status of children less than 5 years of age

OBJECTIVE To analyze if the nutritional status of children aged less than five years is related to the biological conditions of their mothers, environmental and socioeconomic factors, and access to health services and social programs.METHODS This cross-sectional population-based study analyzed 664 mothers and 790 children using canonical correlation analysis. Dependent variables were characteristics of the children (weight/age, height/age, BMI/age, hemoglobin, and retinol serum levels). Independent variables were those related to the mothers’ nutritional status (BMI, hemoglobin, and retinol serum levels), age, environmental and socioeconomic factors and access to health service and social programs. A < 0.05 significance level was adopted to select the interpreted canonical functions (CF) and ± 0.40 as canonical load value of the analyzed variables.RESULTS Three canonical functions were selected, concentrating 89.9% of the variability of the relationship among the groups. In the first canonical function, weight/age (-0.73) and height/age (-0.99) of the children were directly related to the mother’s height (-0.82), prenatal appointments (-0.43), geographical area of the residence (-0.41), and household incomeper capita (-0.42). Inverse relationship between the variables related to the children and people/room (0.44) showed that the larger the number of people/room, the poorer their nutritional status. Rural residents were found to have the worse nutritional conditions. In the second canonical function, the BMI of the mother (-0.48) was related to BMI/age and retinol of the children, indicating that as women gained weight so did their children. Underweight women tended to have children with vitamin A deficiency. In the third canonical function, hemoglobin (-0.72) and retinol serum levels (-0.40) of the children were directly related to the mother’s hemoglobin levels (-0.43).CONCLUSIONS Mothers and children were associated concerning anemia, vitamin A deficiency and anthropometric markers. Living in rural areas is a determining factor for the families health status.

研究目的：分析5岁以下儿童的营养状况与母亲生理状况、环境及社会经济因素、医疗服务可及性和社会项目参与情况的相关性。
研究方法：本研究为基于人群的横断面研究，纳入664名母亲及790名儿童，采用典型相关分析（canonical correlation analysis）开展数据分析。因变量为儿童相关特征：体重/年龄、身高/年龄、体质指数（BMI）/年龄、血红蛋白及血清视黄醇水平；自变量涵盖母亲营养状况相关指标（BMI、血红蛋白及血清视黄醇水平）、母亲年龄、环境与社会经济因素，以及医疗服务可及性与社会项目参与情况。本研究以0.05作为显著性水平筛选具有解读意义的典型函数（CF），并以±0.40作为分析变量的典型载荷阈值。
研究结果：最终筛选出3个典型函数，累计解释组间关联变异的89.9%。在第一个典型函数中，儿童的体重/年龄（-0.73）与身高/年龄（-0.99）与母亲身高（-0.82）、产前检查次数（-0.43）、居住地理区域（-0.41）及人均家庭收入（-0.42）呈正相关；儿童营养相关指标与每间房居住人数（0.44）呈负相关，即每间房居住人数越多，儿童营养状况越差。研究同时发现，农村居民的营养状况更差。在第二个典型函数中，母亲BMI（-0.48）与儿童BMI/年龄及视黄醇水平相关，提示母亲体重越高，儿童体重水平也越高；体重不足的母亲所生儿童更易出现维生素A缺乏。在第三个典型函数中，儿童的血红蛋白（-0.72）与血清视黄醇水平（-0.40）与母亲血红蛋白水平（-0.43）呈正相关。
研究结论：母亲与儿童在贫血、维生素A缺乏及人体测量学指标方面存在显著关联；居住于农村地区是影响家庭健康状况的决定性因素。