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Greater Length-for-age Increases the Odds of Attaining Motor Milestones in Vietnamese Children Aged 5-18 Months

越南5-18個月的幼兒較高的年齡別身長有利於達到動作發展里程碑

摘要


幼兒早期的營養不良與延緩成長具有相關性。然而關於幼年期成長遲緩的時間點之資料有限。使用世界衛生組織(WHO)的粗大動作發展時程來評估動作里程碑(MM)的達到性。針對158名來自隨機社區介入試驗的5-18個月的越南幼兒執行第二次基線資料分析。比較達到動作里程碑的年齡中位數與WHO報告的中位數。使用多變項邏輯斯迴歸分析以確認社經地位、體位及飲食因素與達到動作里程碑之相關性。計有34%的兒童為發育遲緩。越南兒童達到MM的年齡中位數比起WHO的所有MM中位數慢了2.4-3.7個月。較高的年齡別身長增加在協助行走、自行站立及獨立行走的動作達到機率3倍以上。較重的年齡別體重提高用手腳爬行動作的機率3.6倍。同樣的,每日副食品餵食提高了3.6倍協助站立的動作達到機率。這是第一次將WHO動作發展時程應用在越南,顯示學齡前兒童達到動作里程碑的年齡中位數晚於WHO的報告。發育遲緩的高盛行率和年齡別身長與達到動作里程碑的相關性,突顯出解決慢性營養不良對理想的生長及發育的重要性。

關鍵字

發育 生長 越南 學齡前兒童 動作里程碑

並列摘要


Early childhood malnutrition has been associated with delayed development. Limited data exist however about the timing of developmental delay early in life. We assessed motor milestone (MM) achievement using the World Health Organization's windows of achievement for gross motor milestones. We performed secondary analysis of baseline data of 158 Vietnamese children aged 5-18 months from a randomized community intervention trial. Median age of motor milestone achievement was compared to WHO reported medians. Multivariate logistic regression was used to identify socioeconomic, anthropometric and dietary factors associated with motor milestone achievement during the windows of achievement. Thirty four per cent of the children were stunted. Median age of MM achievement of Vietnamese children lagged by 2.4-3.7 months, compared to the WHO median for all MMs. Greater length-for-age increased the odds for walking with assistance, standing alone and walking alone by more than 3 times. Greater weight-for-age increased the odds by 3.6 for hand-and-knees crawling. Likewise, frequency of daily complementary feeding raised the odds by 3.6 for standing with assistance. In this first application of WHO windows of achievement in Viet Nam, pre-schoolers achieved motor milestones later than WHO reported median age. High prevalence of stunting and association of length-for-age with motor milestone achievement underscore the importance of addressing chronic malnutrition to optimize children's growth and development.

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