儿童在资源乏的环境中成长迟缓的原因和后果
Andrew Mertens1, Jade Benjamin-Chung2,3,4, John M Colford2
1Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, CA, USA. amertens@berkeley.edu.
Nature
|September 13, 2023
概括
改善孕产妇的健康和出生状况显著减少了儿童的发育迟缓. 早期干预至关重要, 因为男孩和早期缺陷患者面临更高的风险和死亡率.
科学领域:
- 儿童医学
- 全球健康
- 发育生物学
背景情况:
- 儿童成长迟缓,包括发育迟缓和消耗, 造成短期和长期的健康风险.
- 目前的干预措施还不足以应对低收入和中等收入国家的高增长负担.
- 确定干预的关键窗口对于有效的预防策略至关重要.
研究的目的:
- 分析人口干预对儿童生长迟缓的影响.
- 确定主要的暴露和年龄窗口,以进行有效的预防干预.
- 了解母亲和早期生活因素对成长轨迹的影响.
主要方法:
- 对33个纵向队列进行人口干预效应分析,其中包括83,671名儿童和662,763项测量.
- 分析30个单独的风险,以评估它们对增长参数的影响.
- 检查与出生至2岁的生长缺陷相关的死亡率.
主要成果:
- 改善的母体人体测量和出生状况增加了长度对年龄的z-score高达0. 40分,体重对长度的z-score高达0. 15分.
- 与女孩相比,男孩表现出所有形式的生长迟缓的风险始终较高.
- 早期的产后生长迟缓是随后持续生长缺陷和死亡率增加的强有力的预测因素 (HR 1.98.7).
结论:
- 产前因素和早期生活条件是儿童成长的关键决定因素.
- 专注于预孕和怀孕为新的预防性干预提供了关键机会.
- 针对早期生长缺陷对于降低儿童死亡率和改善长期健康结果至关重要.
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