Survey on vitamin A deficiency in children under-6-years in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the prevalence and spatial distribution of vitamin A deficiency (VAD) in China among children at ages under six years.</p><p><b>METHODS</b>About 8,600 children under 6 years of age in 14 cities and 28 counties of 14 provinces were selected with stratified cluster sampling for survey, including interview with questionnaire for their family information and nutritional status. Blood specimens were collected for measuring serum level of VA with fluorescent spectrophotometry in laboratory.</p><p><b>RESULTS</b>Totally, 8,669 children under 6 (2,877 in urban area and 5,792 in rural area) were surveyed in 14 provinces, with 4,629 males and 4,040 females. Eight cases of night blindness and seven cases of xerophthalmia were found among the children at ages of two to five years. Sixty-one mothers of the children in this group were also found suffering from night blindness. All the cases of night blindness and xerophthalmia both in children and mothers were living in rural areas. Based on their serum levels of VA, 11.7% of the all 1 018 children were diagnosed as VAD, with serum VA concentrations below or equal to 0.70 micro mol/L. Prevalence of VAD was 15.0% and 5.8% in rural (23.3% in the poverty-stricken counties) and urban areas, respectively, and 5.8%, 11.5% and 16.8% in the coastal, inland and remote areas, respectively. The average serum level of VA was 1.20 micro mol/L and 0.99 micro mol/L for urban and rural areas, respectively, with a national average of 1.06 micro mol/L. And, babies under six months of age with an average serum levels of VA < or = 0.70 micro mol/L accounted for 33.4%, and those at ages of four to five years with the same level of VA accounted for 8%. There was significant difference in serum levels of VA between ages, but no significant difference between genders.</p><p><b>CONCLUSION</b>VAD did exist in children of China, especially in the remote and poverty-stricken rural areas and VA supplementation is urgently needed for the children in these regions.</p>

Sampling survey on low-birth weight in China in 1998 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the weight of live births and incidence of low-birth weight (LBW) in China.</p><p><b>METHODS</b>A national survey on the weight of live births with gestational ages of 28 weeks or over in 16 cities and 28 counties of 11 provinces in China was carried with stratified sampling during July to October, 1998.</p><p><b>RESULTS</b>Totally 22 350 live newborns, 11 584 males and 10 766 females, with gestational ages of 28 weeks or more in sampling sites were measured at their birth. Rates of multiple births and preterm birth (< 37 weeks of gestation) were 1.8% and 3.5%, respectively. LBW rates were 4.20% and 6.26% for urban and rural areas, respectively, with a national weighted-average of 5.87%. Full term births (>/= 37 weeks of gestation) accounted for 61.2% and 71.6% of the babies with LBW in national and rural areas, respectively. Their average birth weight was 3 301 g and 3 225 g in urban and rural areas, respectively, with statistically significant difference, and 3 280 g and 3 173 g for boys and girls, respectively, approaching to the values recommended by the World Health Organization (WHO). Live birth weight in the coastal, inland, and remote areas appeared a trend of gradual decrease. Early neonatal mortality of babies with LBW was 50.0 per thousand and 179.4 per thousand in urban and rural areas, respectively, with a national average of 151.5 per thousand, significant higher than those with normal birth weight.</p><p><b>CONCLUSIONS</b>The average birth weight and LBW rate in live births of China were close to those in the developed countries, and there was significant difference in them between varied regions. The majority of LBW in China was attributed to intrauterine growth retardation (IUGR). Early neonatal mortality in babies with LBW was significantly higher than that with normal birth weight. Further intervention measures should be implemented.</p>

A national sampling survey on birth weight in 1998 in China: mean value and standard deviation / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the distribution of live birth weight in China.</p><p><b>METHODS</b>A national survey on live birth weight was performed during July-October, 1998 in China, with stratified sampling. Totally, 22 350 live newborns (11 584 males and 10 766 females) with 28 weeks or more of gestation were measured for their birth weight in the sampling sites during 1998.</p><p><b>RESULTS</b>The ratio of male to female newborns measured was 1.08. The rates of multiple birth and preterm birth (< 37 weeks of gestation) were 1.8% and 3.5%, respectively. Live birth weight was higher in the urban areas (3 301 g) than that in the rural area (3 225 g) (t = 9.4. P < 0.001), the highest in the coastal areas (3 262 g), middle in the inland areas (3 254 g) and the lowest in the remote areas (3 115 g) (F = 177.9, P < 0.001), with a decreasing trend. Live birth weight in the first-class rural areas approximated to that in the urban areas, and that in the second-class, third-class and fourth-class rural areas decreased significantly. The average live birth weight in the fourth-class rural areas was 200 g lower than that in the urban areas.</p><p><b>CONCLUSIONS</b>Generally, the average live birth weight in China was closed to that in the developed countries. But, a big difference in the average live birth weight between regions with varied economic development and health care condition was observed. An intervention measure should be implemented in the poverty-stricken rural areas to increase their average live birth weight.</p>

A case-control study on risk factors for low birth weight in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To identify the risk factors for low birth weight (LBW) in Chinese newborns with varied characteristics.</p><p><b>METHODS</b>A 1:1 matched case-control study, with 999 babies of LBW was performed in 44 counties of 11 provinces in China during July to October, 1998 for identifying their risk factors using simple and multivariate logistic regression models.</p><p><b>RESULTS</b>The determinants of LBW in China included factors, such as multiparity (OR = 106.9), preterm birth (OR = 18.7), abnormal maternal health status (OR = 2.61) and maternal malnutrition (OR = 3.42), maternal medical conditions during pregnancy (OR = 1.93), maternal schooling (OR = 1.43), et al. Distribution of the risk factors for LBW was significantly different between coastal, inland and remote areas. LBW was mainly attributed to intrauterine growth retardation (IUGR) (71.6%) in the rural areas, and to multiparity and preterm birth, in addition to IUGR, in the urban areas. There was different in the risk factors for LBW with preterm births and IUGR.</p><p><b>CONCLUSIONS</b>It is an effective way to reduce incidence of low birth weight in China that all measures for prevention and control should be relevant to its risk factors.</p>

Prevalence of subclinical vitamin A deficiency and its affecting factors in 8 669 children of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>The survey will reveal current status of subclinical vitamin A deficiency (SVAD) and explore its affecting factors in children of China.</p><p><b>METHODS</b>Totally 8 669 children aged under 6 years were randomly selected from 14 provinces for clinical examination, health and dietary questionnaire and serum level of vitamin A measurement with fluorescence method. The cut-off value for SVAD was defined as </= 0.70 micro mol/L.</p><p><b>RESULTS</b>Prevalence of SVAD was 11.7% and that of suspected SVAD 39.2% in all subjects, which decreased with the increase of gross domestic product, average annual family income, mother's schooling and children's age. Prevalence of SVAD and suspected SVAD higher in rural areas (15.0%) than in urban areas (5.2%), and higher in children with a minority mother (22.6%) than in those with a Han nationality mother (8.7%). Prevalence of SVAD and suspected SVAD was higher in children whose blood samples were collected within one week in-taking vitamin A-rich food (12.6%-22.6%) than those in-taking vitamin A daily (4.1%-10.0%), and higher in children suffering from respiratory infection, fever and diarrhea two weeks before their blood collection (15.2%-20.3%) than in those without those diseases (10.1%-11.1%). Logistic regression analysis showed that poor family economic status, living in rural areas, children with a minority mother, younger age, no-dairy milk products intake, and respiratory infection and fever all were risk factors for SVAD.</p><p><b>CONCLUSIONS</b>More than half of children under six years old in China (50.9%) had vitamin A nutrition problem. Varied factors played roles to different extent in SVAD in children.</p>