| Objective: To understand the status of height growth,the incidence of stunting and its trend among children under 5 years old,and to explore the related factors of stunting,including the family factors,maternal factors during pregnancy and individual factors,which could provide theoretical basis and suggestions for preventing the occurrence of childhood stunting.It is of significance to decrease the prevalence of stunting and promote child health.Methods: Newborns born in the service area of three community health service centers in Kaifu District,Changsha City in 2015 were selected as the research objects and a birth cohort was established.Children were followed up at age of 1,3,6,8,12,18,24,36,48 and 60 months,and information was collected using the self-designed maternal and infant questionnaire,combined with the maternal and child health handbook.Using mean and standard deviation to describe the change of children’s length or height,and using rate to show the incidence of stunting.The difference between the study and the national growth level of children was compared by student’s t-test.The influencing factors of child stunting was analyzed by generalized estimating equations.Results:(1)With the increase of age,children’s length or height increased continually.The average length or height of children in this study was low contrasted to the national growth level of children and the difference was statistically significant among children aged 0～60 months(P<0.05).(2)The incidence of stunting was 3.07%(95%CI=1.71%～4.44%)in children aged 1 month,1.94%(95%CI=0.85%～3.03%)in children aged3 months,1.46%(95%CI=0.51%～2.40%)in children aged 6 months,1.46%(95%CI=0.51%～2.40%)in children aged 8 months,2.10%(95%CI=0.97%～3.23%)in children aged 12 months,1.94%(95%CI=0.85%～3.03%)in children aged 18 months,2.10%(95%CI=0.97%～3.23%)in children aged 24 months,0.97%(95%CI=0.20%～1.74%)in children aged 36 months,2.10%(95%CI=0.97%～3.23%)in children aged 48 months and 3.24%(95%CI=1.84%～4.63%)in children aged 60 months.The change trend of stunting displayed roughly a W-shaped.Among all follow-up months,the incidence of stunting was higher at 1 month and 60 months,and the lowest at 36 months.(3)The results of multivariate analysis via generalized estimating equations showed that taller mother(RR=0.86,95%CI=0.80～0.93),taller father(RR=0.88,95%CI=0.83～0.93),the duration of outdoor activity ≥1 h/d(RR=0.51,95%CI=0.28～0.90)or ≥2 h/d(RR=0.37,95%CI=0.23～0.61)were associated with a decreased risk of child stunting(P<0.05),while mother with gestational hypertension(RR=2.89,95%CI=1.46～5.72),child born less than 37 weeks(RR=9.04,95%CI=3.45～23.67)and child with respiratory diseases(RR=1.46,95%CI=1.06～2.02)were associated with a increased risk of child stunting(P<0.05).Conclusions: The length or height of children under 5 years old in this study is lower than the national children,and the incidence of stunting is less than 5% with a roughly W-shaped change from children aged 1 month to 60 months.Many factors can affect the occurrence of child stunting,children with tall parents and outdoor activity time ≥1 h/d have a low risk of stunting,and children with mothers with gestational hypertension,gestational age less than 37 weeks and respiratory diseases have a high risk of stunting. |
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