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Abstract
Objective To investigate the prevalence of malnutrition among 2-year-old children in Fangchenggang, Guangxi Zhuang Autonomous Region, and analyze its associated factors, so as to provide a scientific basis for developing targeted intervention strategies against childhood malnutrition. Methods A total of 447 two-year-old children with established health records in the Fangchenggang, Guangxi Zhuang
Autonomous Region from June to December 2021 were enrolled by random sampling combined with a
retrospective study design. According to body mass status, the children were divided into underweight group (n=50) and non-underweight group (n=397), wasting group (n=45) and non-wasting group (n=402), and stunting group (n=39) and non-stunting group (n=408), respectively. Associated factors of malnutrition were systematically analyzed, and multivariate Logistic regression analysis was performed to identify influencing factors for underweight, wasting and stunting in these children. Statistical analysis was performed using the χ2 test. Results In Fangchenggang, the prevalence rates of underweight, wasting, and stunting among 2-yearold children were 11.2% (50/447), 10.1% (45/447), and 8.7% (39/447), respectively. The underweight group showed significantly higher proportions of male, non-Han Chinese maternal ethnicity, maternal education level below junior college, full-time maternal homemaker status, non-Han Chinese paternal ethnicity, low birth weight, breastfeeding duration >12 months, and non-diverse diet compared with the non-underweight group [66.6% (33/50) vs 49.9% (198/397), 50.0% (25/50) vs 30.0% (119/397), 94.0% (47/50) vs 80.9% (321/397), 62.0% (31/50) vs 45.8% (182/397), 54.0% (27/50) vs 31.5% (125/397), 24.0% (12/50) vs 9.8% (39/397), 26.0% (13/50) vs 12.6% (50/397), 92.0% (46/50) vs 79.1% (314/397); χ 2 values were 4.624, 8.155, 5.273, 4.647, 10.030, 8.829, 6.591, and 4.719, respectively; all P<0.05]. The proportions of rural household residence, maternal education below junior college level, non-Han Chinese paternal ethnicity, paternal education below junior college level, low birth weight, and breastfeeding duration exceeding 12 months in the wasting group were significantly higher in the non-wasting group [88.9% (40/45) vs 60.2% (242/402), 93.3% (42/45) vs 81.1% (326/402), 48.9% (22/45) vs 32.3% (130/402), 93.3% (42/45) vs 78.9% (317/402), 22.2% (10/45) vs 10.2% (41/402), 26.7% (12/45) vs 12.7% (51/402); χ 2 values were 14.304, 4.166, 4.940, 5.365, 5.788, and 6.533, respectively; all P <0.05]. The proportions of non-only-child families, introduction of complementary feeding at <4 months, and introduction of complementary feeding at >6 months in the stunting group were all higher than those in the non-stunting group [84.6% (33/39) vs 67.9% (277/408), 12.8% (5/39)
vs 5.6% (23/408), and 28.2% (11/39) vs 15.2% (62/408), χ 2 values were 4.684 and 8.496, respectively all P<0.05]. Multivariate Logistic regression analysis showed that gender (OR=2.436, 95% CI: 1.258-4.727), maternal ethnicity (OR=2.143, 95% CI: 1.118-4.106), maternal education level (OR=4.060, 95% CI: 1.149- 14.339), full-time homemaker mother (OR=2.132, 95% CI: 1.092-4.162), paternal ethnicity (OR=2.200, 95% CI: 1.157-4.183), low birth weight (OR=3.218, 95% CI: 1.442-7.181), and duration of breastfeeding cessation (OR=3.196, 95% CI: 1.469-6.954) were influencing factors for underweight in 2-year-old children. Place of residence (OR=6.179, 95% CI: 2.343-16.295) and duration of breastfeeding cessation (OR=3.275, 95% CI: 1.526-7.026) were influencing factors for wasting in 2-year-old children. Being from a single-child family (OR=2.519, 95% CI: 1.025-6.189) was an influencing factor for stunting in 2-year-old children. Conclusion The prevalence of malnutrition among 2-year-old children in Fangchenggang is relatively high. The gender, maternal ethnicity, maternal education level, full-time homemaker mother, paternal ethnicity, low birth weight, and duration of breastfeeding cessation were influencing factors for underweight. Place of residence and duration of breastfeeding cessation were influencing factors for wasting. Being from a single-child family was an influencing factor for stunting. It is necessary to strengthen prenatal health care as well as child monitoring and feeding guidance to promote healthychild growth and development.
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