Objective:To develop hemoglobin (Hb) percentiles and thresholds for defining anemia among infants aged 0-5 months in China. Methods:The National Nutrition and Health Systematic Survey for children aged 0 -17 years in China, a nationwide cross-sectional study, was conducted between 2019 and 2021. Hb levels were measured in infants using the HemoCue 201+ analyzer. Age- and sex-specific Hb distributions were constructed for "healthy infants", defined as those with adequate iron reserves at birth, exclusive breastfeeding, normal weight-for-age Z-score and weight growth velocity, normal neuropsychological development, and absence of acute or chronic diseases. A generalized additive model for location, scale, and shape was applied to fit the Hb percentiles. The 5th percentile of the Hb distribution was defined as the threshold for anemia. Results:A total of 10,174 infants aged 0-5 months participated in the study, among whom 2,155 healthy infants were included in the analysis. Hb levels peaked at birth, gradually decreased to a nadir around 60 days after birth, and then rose to a plateau. The Hb thresholds defining anemia were 102.7 g/L, 96.3 g/L, 92.8 g/L, 95.4 g/L, 97.1 g/L, and 95.8 g/L for the 0-, 1-, 2-, 3-, 4-, and 5-month age groups, respectively. Conclusion:This study establishes hemoglobin thresholds for defining anemia in infants aged 0-5 months based on a nationwide, population-based dataset in China.

Early life exposure to fine particulate matter (PM2.5) is linked to child development, but limited studies have focused on the specific constituents of PM2.5, and the potential moderating role of residential greenness remains unknown. The aim of this study is to investigate the effects of constituent-specific PM2.5 on child development and explore the moderating role of greenness. This study included 8327 children aged 1–6 years from a nationwide cross-sectional survey in China. We assessed PM2.5 and its five compositions across six exposure windows, covering the preconception, prenatal, and the year before the developmental assessment. Developmental quotients (DQ) across five domains were examined using the Children’s Developmental Scale of China to assess the child development. Greenness was estimated using the Normalized Difference Vegetation Index within a 1000-m buffer (NDVI1000m). Multivariable linear regression models were used to evaluate the associations of PM2.5, its constituents, and child DQ, as well as the effect modification by NDVI1000m. PM2.5 and its constituents were negatively associated with child DQ in motor, adaptability, and social skills. These effects varied by DQ domains and constituents, fine and gross motor domains showed more consistent negative associations, and stronger associations were observed for black carbon (BC), organic matter, and sulfates. Especially, PM2.5 and all five compositions across six windows were consistently associated with lower fine motor DQ [e.g., β = − 4.66, 95

The relationship between screen exposure and early childhood development requires further investigation, especially regarding the age at screen onset, daily screen duration, and potential gender-specific vulnerabilities. This study explored the associations between screen exposure before the age of two and domain-specific developmental outcomes, with particular emphasis on to age of onset, daily exposure duration, and gender differences. This cross-sectional study was conducted as part of the China National Nutrition and Health Systematic Survey for Children Aged 0–17 Years (CNHSC, 2019–2021). A total of 4617 children under the age of two were included. Parents reported their children’s screen exposure history, and developmental outcomes were assessed using the China Development Scale for Children (CDSC, WS/T580-2017). Propensity score matching was applied to minimize potential confounding and selection bias. Three-level linear mixed-effects models were used to assess associations with age at onset, daily screen time, and gender interactions. Among participants (49.7

Objective:This study aimed to describe 24-hour movement behaviors, including physical activity, sedentary behavior, and sleep period, among Chinese preschoolers using nationally representative data, and examine disparities by age, gender, and residence. Methods:A cross-sectional analysis was conducted using data from the China National Nutrition and Health Systematic Survey for Children (2019-2021), including 10,935 children aged 3-5 years. Daily total time of physical activity (TPA), total time of sedentary behaviors (TSB), and total sleep period (TSP) was collected via validated structured questionnaires. Physical inactivity was defined as < 180 minutes of TPA per day. Results:Median TPA was 121.4 ( IQR: 71.4-209.6) minutes/day, and TSB was 231.4 ( IQR: 175.0-304.3) minutes/day, with 11.46 ± 1.00 hours/day average TSP. Overall, 68.8% were physically inactive, with higher prevalence in rural (73.3%) versus urban areas (64.8%, P < 0.001). TPA and TSB increased with age, while TSP decreased (all P < 0.001). No significant gender differences were observed. Conclusion:Most Chinese preschoolers exhibit insufficient physical activity and excessive sedentary behaviors, with notable urban-rural disparities and an escalating trend of ageing. Continuous monitoring and targeted interventions, especially in rural areas, are urgently needed.

BACKGROUND:Selenium is essential for children's health and either deficiency or excess could pose serious health risks. However, nationwide data on selenium nutrition in Chinese children are still lacking, as current studies were primarily limited to historically deficient regions affected by Keshan disease and Kashin-Beck disease. OBJECTIVES:This study aims to investigate the relationship between the living environment, geographic factors, dietary intake, and the selenium status of Chinese children aged 3-17 y. METHODS:Data were derived from the National Nutrition and Health Systematic Survey for children aged 0-17 y (CNHSC), conducted between 2019 and 2021. Field surveys were conducted to collect general demographic information, and a food frequency questionnaire was used to assess dietary intake. Blood selenium concentrations were measured using inductively coupled plasma mass spectrometry (Agilent 7700x), with a cutoff value of 70 μg/L indicating inadequate selenium status. RESULTS:The results revealed that the blood selenium concentration of children aged 15-17 y (92.93 μg/L) was higher than that of other age groups. Additionally, children from rural western areas, with a selenium concentration of 83.28 μg/L, were significantly more vulnerable to inadequate selenium status compared with those from eastern cities [odds ratio (OR) = 20.56 (10.77-39.25)]. Dietary intake of dairy products [OR = 0.58 (0.44-0.75)], meats [≥7 times/wk: OR = 0.48 (0.36-0.64), 3-7 times/wk: OR = 0.65 (0.48-0.90)], and aquatic products [OR = 0.53 (0.37-0.75)] were identified as protective factors against inadequate selenium status (P < 0.001). CONCLUSION:This study suggests that children in rural western areas may be a priority population for future interventions to improve selenium status. A moderate increase in the consumption of selenium-rich foods, such as dairy products, meats, and aquatic products, is recommended to reduce the prevalence of inadequate selenium status in these regions.

OBJECTIVE:To provide updated prevalence and associated factors of double burden of malnutrition(DBM) among children aged 6-17 months in China. METHODS:This study was a cross-sectional study. A multi-stage stratified randomized sampling method was used to recruit 25 791 children aged 6-71 months from 14 provinces in China between 2019 and 2021. A standardized questionnaire survey was used to collect basic information about children and their parents. All children were weighted using unified digital weight scales, and the length/height of all children was determined using unified instruments. Hemoglobin of all children was collected using a HemoCue 201+ system. The body mass index for age Z-scores and anemia were determined and used to evaluate the prevalence of double burden of overweight/obesity and anemia malnutrition. The chi-square test was used to compare the prevalence of malnutrition among children with different characteristics. The unconditional logistic regression model was used to examine factors associated with the malnutrition. RESULTS:This study included 25 791 children aged 6-71 months, including 5127 children aged 6-11 months, 6592 children aged 12-23 months, 3605 children aged 24-35 months, 3492 children aged 36-47 months, 3559 children aged 48-59 months, and 3416 children aged 60-71 months. The prevalence of double burden of overweight/obesity and malnutrition among children aged 6-71 months was 0.8%(n=210).12-23 months(OR=0.69, 95%CI 0.42-0.83), 24-35 months(OR=0.33, 95%CI 0.19-0.55), 36-47 months(OR=0.14, 95%CI 0.06-0.30), 48-59 months(OR=0.26, 95%CI 0.14-0.48), 60-71 months(OR=0.46, 95%CI 0.28-0.75), father&apos;s age of 40-44years(OR=0.40, 95%CI 0.17-0.97) and higher education levels of father(OR=0.40, 95%CI 0.17-0.97) were the protective factors for DBM(P&lt;0.05), whereas large-for-gestational-age infants(LGA)(OR=1.73, 95%CI 1.13-2.66), non-only-child(OR=1.58, 95%CI 1.14-2.19), central regions(OR=1.64, 95%CI 1.11-2.43) and rural area(OR=1.45, 95%CI 1.05-2.00)were the risk factors for DBM(P&lt;0.05). CONCLUSION:The prevalence of DBM among children aged 6-71 months in 14 provinces in China was at a relatively low level. The occurrence of overweight/obesity and anemia malnutrition was impacted by children age, LGA, non-only-child, age of father, education levels of father and regions.

OBJECTIVE:To explore the relationship between feeding patterns and physical growth of late preterm infants with 34-36 weeks of gestational age and 0-5 months of correction age. METHODS:The data were from the project "Nutrition and Health System Survey and Application for Children aged 0-18 Years in China". Multi-stage stratified random sampling was used to conduct the study at 28 survey sites in 7 regions of East China, North China, Central China, South China, Southwest, Northwest and Northeast China from February 2018 to January 2020. A self-designed structured questionnaire for infants aged 0-6 months was used by the investigators to ask infant mothers or other primary guardians face-to-face to retrospectively collect the basic characteristics and feeding status of infants, and measure the length, weight and head circumference of infants. Based on inclusion criteria and exclusion criteria, a total of 48 late preterm infants fed exclusively breastmilk and 53 late preterm infants fed formula aged 0-5 months of correction age were enrolled in this study. Using the corrected age and gender of late preterm infants fed exclusively breastmilk as matching variables, 48 full-term infants fed exclusively breastmilk aged 0-5 months were matched by propensity score as reference to evaluate the difference in growth and development between late preterm infants and full-term infants fed exclusively breastmilk. Z-scores and weight gain rate were used to evaluate the growth and development of infants. ANOVA was used to compare the growth and development of infants in the three groups. Multiple linear regression was used to adjust for potential confusing factors to analyze the effects of different feeding patterns on the growth and development of late preterm infants. RESULTS:There was no significant difference in length for age Z-score(LAZ), weight for age Z-score(WAZ), weight for height Z-score(WLZ), body mass index for age Z-score(BAZ) and weight gain rate between late preterm infants fed exclusively breastmilk and late preterm infants fed formula(P&gt;0.05), and there was also no significant difference between late preterm infants fed exclusively breastmilk and full-term infants fed exclusively breastmilk(P&gt;0.05). However, The WAZ and head circumference for age Z-score(HCZ) of late preterm infants fed formula were 0.41(P=0.03) and 0.44(P=0.02) higher than those of full-term infants fed exclusively breastmilk, but there was no significant difference in LAZ, WLZ, BAZ and weight gain rate between the two groups(P&gt;0.05). CONCLUSION:At 0-5 months of correction age, the growth and development of late preterm infants fed exclusively breastmilk were similar to that of full-term infants fed exclusively breastmilk. Formula supplementation may promote weight gain, but not length in late preterm infants.

BACKGROUND:Emerging evidence suggests that exposure to particulate matter (PM) may exert neurotoxic effects, but its impact on neurodevelopment during early life remains poorly understood. This study aims to investigate the association between prenatal and postnatal exposure to PM with varying sizes and neurodevelopmental outcomes. METHODS:This study was based on a nationwide survey of 11,439 children residing in 16 provinces in China. The concentrations of PM with aerodynamic diameters of < 1 μm, 2.5 μm, and 10 μm (PM1, PM2.5, PM10) at the children's residences were estimated using spatial-temporal models. Neurodevelopment was assessed using the China Developmental Scale for Children (0-6 years), which evaluates total developmental quotient (DQ) and DQ across five domains. Multi-variable linear regression models were used to estimate the association between PM exposure and DQ. RESULTS:Both prenatal and postnatal exposure to PM was associated with a reduction in total DQ and DQ in domains including gross motor, fine motor, adaptive behavior, and social behavior. Particles with smaller size showed stronger adverse effects. For instance, a 10 μg/m³ increase in the concentrations of PM10, PM2.5, and PM1 throughout pregnancy was associated with reductions in total DQ of 0.44, 0.52, and 0.74, respectively. Corresponding reductions related to the postnatal exposure during the first two years after birth were 0.46, 0.58, and 0.97, respectively. The fine motor domain was most strongly affected by PM exposure, followed by gross motor. The associations were particularly pronounced among children aged ≥ 24 months, those breastfed for less than 6 months, and those residing in northern China. CONCLUSIONS:Our findings provide robust evidence of the adverse neurodevelopmental effects of early-life exposure to PM. This research identifies the most impacted developmental domains, highlights the most harmful particle size, and underscores vulnerable subgroups， which have significant implications for public health and pollution control.

Objective: The aim of this study was to explore the relationship between breastfeeding duration and neurodevelopment in children aged 2 to 3 years in a Chinese population. Methods: This study was based on a cross-sectional survey. The data were from the National Nutrition and Health Systematic Survey for children in China which was conducted from 2019 to 2020. Characteristics of parents and children and the breastfeeding duration were obtained using interview-administered questionnaires. Children's neuropsychological development was assessed by a trained child health care physician using the Child Psychological Development Scale. A multivariable linear regression model was used to analyze the association between breastfeeding duration and neuropsychological development. Results: A total 1290 children aged 2-3 years were included in the present analysis. In multivariable linear regression models, after adjustment for potential confounders, children who were breastfed for 7-12 months had a 3.59-point increase in gross motor development ((3 = 3.59; 95% confidence interval [CI]: 1.23 to 6.34), a 3.73-point increase in fine motor development ((3 = 3.73; 95 % CI: 1.09 to 6.47), and a 2.87-point in language development ((3 = 2.87; 95 % CI: 1.12 to 5.31) compared with those who were never breastfed. Children who were breastfed for > 12 months had a 3.77-point increase in fine motor development ((3 = 3.77; 95 % CI: 0.98 to 6.86) compared with those who were never breastfed. Conclusions: Longer breastfeeding duration was associated with increased gross motor, fine motor, and language scores in our study population. Mothers in China should be encouraged to initiate and continue breastfeeding.

Objective This study aimed to assess the relationship between the body composition of children aged 3-5 years and breastfeeding status and duration.Methods The study was conducted using data from the National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC), a nationwide cross-sectional study. Breastfeeding information and potential confounders were collected using standardized questionnaires administered through face-to-face interviews. The body composition of preschool children was measured using bioelectrical impedance analysis. A multivariate linear regression model was used to assess the relationship between breastfeeding duration and body composition after adjusting for potential confounders.Results In total, 2,008 participants were included in the study. Of these, 89.2% were ever breastfed and the median duration of breastfeeding was 12 months (IQR 7-15 months). Among children aged 3 years, the height-for-age Z-score (HAZ) for the ever breastfed group was lower than that for never breastfed group (0.12 vs. 0.42, P = 0.043). In addition, the weight-for-age Z-score (WAZ) of the ever breastfed group was lower than that of the never breastfed group (0.31 vs. 0.65, P = 0.026), and the WAZ was lower in children aged 4 years who breastfed between 12 and 23 months than in those who never breastfed. Compared to the formula-fed children, the fat-free mass of breastfed infants was higher for children aged 3 years (12.84 kg vs . 12.52 kg, P = 0.015) and lower for those aged 4 years (14.31 kg vs. 14.64 kg, P = 0.048), but no difference was detected for children aged 5 years (16.40 kg vs. 16.42 kg, P = 0.910) after adjusting for potential confounders. No significant difference was detected in the weight-for-height Z-score (WHZ), body mass index (BMI)-for-age Z-score (BAZ), fat-free mass index, and body fat indicators in the ever breastfed and never breastfed groups and among various breastfeeding duration groups for children aged 3-5 years.Conclusion No obvious associations were detected between breastfeeding duration, BMI, and fat mass indicators. Future prospective studies should explore the relationship between breastfeeding status and fat-free mass.

目的 了解0～23月龄婴幼儿大运动发育情况及其影响因素.方法 采用"儿心量表-Ⅱ"对全国20省市3 739名0～23月龄婴幼儿大运动发育商进行测查,同时采用问卷调查收集婴幼儿及其抚养人的相关信息.结果 出生体质量(β=-0.666,P=0.002)、主要抚养人(β=-0.395,P=0.000)、喂养方式(β=-0.250,P=0.011)、添加辅食(β=0.441,P=0.000)及家庭月均收入(β=0.189,P=0.005)与儿童大运动发育商的差异有统计学意义(P＜0.05).结论 低出生体质量不利于儿童大运动发育,母亲作为主要抚养人且家庭月均收入较高对孩子的大运动发育具有一定的促进作用.在喂养方面,坚持纯母乳喂养、适时添加辅食有助于大运动发育.

Objective The purpose of this survey was to explore the association of delivery mode with overweight and neurodevelopment of Chinese infants aged 1–5 months. Materials and methods This study was based on a cross-sectional survey. Data for this study were obtained from the Children’s Nutrition and Health System Survey in China which was conducted from 2019 to 2020. Characteristics of parents and children and the delivery mode were obtained using interview-administered questionnaires. Body mass index-for age z-score (BMI z) was calculated using World Health Organization (WHO) child growth standards. Children’s neurodevelopment was assessed by a trained child health care physician using the Child Psychological Development Scale. The association of delivery mode with infant overweight was analyzed using a multivariable logistic regression model. We conducted a multivariable linear regression model to explore the relationship between delivery modes with neurodevelopment. Results In total, the present analysis included 1,347 children aged 1–5 months, 35.61% were born via cesarean section, of which 15.21% were overweight. After adjustment for infant characteristics and parental factors, the cesarean section was significantly related with the likehood of being overweight [OR = 1.95; 95% confidence interval (CI): 1.27 to 2.98]. Children born via cesarean section had a 3.41-point decrease in gross motor development (β = −3.41; 95% CI: −5.77 to −1.05), a 3.65-point decrease in fine motor development (β = −3.65; 95% CI: −6.03 to −1.28), and a 2.96-point in language development (β = −2.96; 95% CI: −5.20 to −0.73), a 1.65-point in total development (β = −1.65; 95% CI: −3.17 to −0.14) compared with those who were vaginal birth. Conclusion In our study population, cesarean section was associated with overweight and neurodevelopment outcomes. The cesarean section might increase the likehood of infant overweight, and might decrease the developmental scores of gross motor, fine motor and language. Further studies should be conducted to verify the associations and explore the possible mechanisms.

目的 探讨母乳持续时间与学龄前儿童神经心理发育水平的相关性,为促进母乳喂养提供依据.方法 2019年9月—2021年5月选取北京市东城区、吉林省通化市东昌区、山西省晋中市榆次区、河南省周口市川汇区、湖南省长沙市岳麓区、江西省南昌市青山湖区、陕西省渭南市临渭区、广西壮族自治区桂林市七星区及青海省格尔木市990名3～4岁的城市儿童.采用《儿心量表-Ⅱ》对儿童的神经心理发育水平进行测查.儿童及其父母的人口学特征采用面对面问卷调查收集.结果 多元线性回归方程在调整了父母年龄、文化程度、家庭月均收入、孕期增重、生产方式及产次因素后,与母乳持续时间＜6月的儿童相比,母乳持续时间＞12月儿童的大运动发育水平β(95％CI)值为2.51(1.11～3.57),语言发育水平β(95％CI)值为3.62(1.21～4.84),差异均有统计学意义(均P＜0.05).与母乳持续时间＜6月的儿童相比,母乳持续时间6～12月儿童的语言发育水平β(95％CI)值为2.47(1.10～3.28),差异有统计学意义(P＜0.05).结论 母乳持续时间与学龄前儿童大运动、语言发育水平呈正相关关系.因此,鼓励母乳喂养并延长母乳喂养时间有益于儿童神经心理发育.

Aims: The child restraint system (CRS) for vehicles is designed to provide specialized protection for children in the event of a crash. The aim of the study was to investigate the rate of CRS use and analyze the factors associated with CRS use among children aged under six years in China, and to provide further insight into developing strategies for promoting public health education. Methods: This is a cross-sectional study. The study sites were 36 primary healthcare institutions in 12 provinces across China, and the participants were 34,503 guardians of children aged 0–6 years. Guardians who owned private cars were included and completed surveys about their experience using CRS. Odds ratios and 95% confidence intervals were calculated using multivariate logistic regression models. Results: The overall rate of CRS use among children aged under six years in China was 17.3%. Multivariate logistic regression analysis revealed that living in an urban area, low age of the child, guardians having higher education and being looked after by parents had a significant positive association with CRS use among children aged under six years. Conclusions: This study confirms that there is a low rate of CRS use among children aged under six years in China, highlighting the considerable need for CRS use education, advocacy and promotion of increasing use.

OBJECTIVE:To systematically collect basic data on nutrition and health of children aged 6-18 years in China.METHODS:A cross-sectional survey was conducted in 7 regions, including Eastern China, Northern China, Central China, Southern China, Southwestern China, Northwestern China, and Northeastern China. A total of 65 000 children aged 6-18 years were selected from 28 urban and rural survey sites in 14 provinces through multistage stratified random cluster sampling. Through a questionnaire survey, physical examination, laboratory examination, dietary survey, children&apos;s information on dietary intake, physical development, bone development, psychological intelligence, physiological development, and physique were collected to evaluate children&apos;s nutrition and health status; nutrition and health knowledge, physical activity and lifestyle of children and their parents were investigated.RESULTS:The project has basically completed the field investigation and data entry, and it has measured the physical development indicators of 64 999 children aged 6-18 years in China.64 463 completed the student questionnaire; 62 448 completed the body composition measurement, and 3359 completed the assessment of intellectual development.CONCLUSION:This project brings together the nutrition, epidemiology, child care, mental health experts with the centers for disease control and prevention, and maternal and child health care system in our country. Combining with research institutes and children&apos;s hospitals of professional expertise, the project comprehensively collects children&apos;s dietary nutrition, growth and development, and health-related data in our country. It would put forward strategies to improve the children&apos;s nutrition and health in China and provide the basis for data sharing.

Background:Studies have not provided clear enough evidence on the direct association between cigarette smoking and poverty. This study aims to assess the association of householder smoking with near-poverty households, and the potential mediating effect of NCDs.MethodsA cross-sectional survey was conducted from November 2019 to October 2020 in relatively underdeveloped regions in China. In total, 2,409 households were investigated in areas under the jurisdiction of 24 primary health care (PHC) institutions of eight provinces. Pearson's χ2-test was performed, and multivariable logistic regression and extended probit regression models were fitted to examine the association between householder smoking and near-poverty households. Moreover, generalized structural equation modeling was used to explore the mediating effect of NCDs.ResultsAfter adjusting for all other potential confounding factors, compared with households headed by never-smokers, households headed by smokers exhibited significantly elevated risks of being near poverty, with an odds ratio of 2.01 (95% CI: 0.48–0.91). We also found that living in rural areas and having a low education level both had a negative effect on being near poverty. Additionally, NCDs had a significantly positive mediating effect, with a 31.57% effect of householder smoking on near-poverty status mediated by NCDs; the indirect effect was estimated to be 0.17 (95% CI: 0.04–0.31).ConclusionsHouseholder smoking significantly elevated the risk of the household being near poverty, and suffering NCDs had a positive mediating effect.

目的 分析中国学龄前儿童贫血现况及其与不同能区及总体神经心理发育状况的相关关系.方法 数据来源于"中国0～18岁儿童营养与健康系统调查与应用"项目,以14省28个调查点的3 261名2～6岁儿童及其家长为研究对象.儿童相关人口学特征由经过统一培训的调查员进行面对面调查.采用血红蛋白检测方法(Hemocue法)测定儿童全血血红蛋白,儿童的神经心理发育水平由经过培训的儿童保健人员采用《0～6岁儿童发育行为评估量表》(WS/T 580-2017)进行测查.结果 儿童血红蛋白平均水平为(125.23±11.49)g/L,贫血率为10.30％.调整性别、年龄、民族、地区、喂养方式、母孕期情况等混杂因素之后,2～6岁贫血儿童在大运动(β=-2.15,95％CI=-3.89～-0.41)、精细动作(β=-2.46,95％CI=-4.12～-0.79)、适应能力(β=-2.59,95％CI=-4.42～-0.76)、语言(β=-3.65,95％CI=-5.53～-1.78)和社会行为(β=-3.11,95％CI=-4.94～-1.28)5个能区以及全量表(β=-2.79,95％CI=-4.10～-1.49)发育商水平均低于非贫血儿童(P值均＜0.05).结论 2～6岁儿童贫血与其总体发育商以及大运动、精细动作、适应能力、语言和社会行为五大能区发育商水平均呈负相关,建议积极开展学龄前儿童贫血监测、干预工作,进一步提高儿童的神经心理发育水平.

目的 研究分析0～24月龄婴幼儿贫血对不同能区神经心理发育状况的影响.方法 数据来源于"中国儿童心理发育数据分析及报告和图集制作"课题,共4 903名0～24月龄婴幼儿及其家长纳入本研究.儿童及其家长的人口学特征由经过统一培训的调查员进行面对面调查.采用血红蛋白检测方法(Hemocue法)测定全血血红蛋白,儿童的神经心理发育水平由经过培训的儿童保健人员采用"儿心量表-Ⅱ"进行测查.结果 0～24月龄婴幼儿血红蛋白水平是(116.96±13.15)g/L,贫血率为15.56％.在调整性别、月龄、民族、区域、喂养方式、母孕期情况和父母亲年龄、职业和文化程度等因素之后,贫血婴幼儿在精细动作(β值=-2.23,95％CI:-3.54～0.92)、语言(β值=-2.34,95％CI:-3.61～1.06)和全量表(β 值=-1.31,95％CI:-2.17～0.46)的发育商得分显著低于非贫血儿童.在大运动、适应能力和社会行为3个能区,贫血婴幼儿低于非贫血儿童,但差异无统计学意义(P＞0.05).结论 0～24月龄婴幼儿贫血对于婴幼儿总发育商有一定的影响,并且主要表现在精细动作和语言两个能区上.

The main purpose of the National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC) was to collect basic data on the nutrition, development, and health status for children in different regions across China using evidence-based, reliable, and cost-effective approaches. Children and their parents or guardians from seven regions (south, southwest, north, northwest, eastern, central, and northeast China) in China were recruited. A multi-stage stratified randomized sampling method was used. Two provinces were randomly sampled from each of the seven regions, from which one urban district and one rural country were also randomly sampled, resulting in a total of 28 survey counties/districts. Dietary surveys, health examinations, laboratory testing, and questionnaires were used to collect dietary intake, nutritional status, child development, and health status information. Nutrition, health, and lifestyle assessment of children and their parents was determined using the Knowledge Attitude Practice (KAP) survey. Greater than 100,000 children (38,000 children < 6 years of age and 66,000 children 6-17 years of age) completed the survey. The survey provided comprehensive data on child nutrition and health status for future studies and will serve as the basis for an integrated nutrition and health improvement strategies proposal for children in China.

This study aims to explore the attitude, willingness, and satisfaction with contracted service (CS) among staff in community health service (CHS) centers in urban China and to explore the associated factors of satisfaction with CS. From August 2016 to July 2017, five CHS centers in three provinces of China were selected. Setting-level information was collected by official document review; and personal information on demographic characteristics, awareness, willingness, and attitude of CS among staff was collected by questionnaire survey. Univariate and multivariable logistic regression models were fitted to explore the associated factors of satisfaction with CS. Multiple correspondence analysis (MCA) was used to visually demonstrate the correlations among category data related with satisfaction with CS. The CS signing rates were 30.78, 12.72, 22.20, 14.32, and 21.19% in the five CHS centers. A total of 286 staff included family doctors (40.91%), nurses (31.12%), and others (27.97%) completed the survey. For the sense of self-worth, 86.01% (246/286) participants hold a positive attitude. The predominant barrier of CS signing was caused by the work pressure due to CS performance assessment (48.60%, 139/286). About 30% of family doctors and nurses reported a heavy work pressure, and more than 30% of doctors had great feeling of fatigue. Notably, 51.69% family doctors would like to change their job in the future. Compared with other staff, family doctors were more likely to be unsatisfied with CS (OR: 2.793, 95% CI: 1.155–6.754, p = 0.022). Participants in Sichuan province have lower satisfaction than other places. The MCA yielded similar factors consistent with multivariable results of clustering with different levels of CS satisfaction. Our study revealed that the CS coverage and satisfaction among staff from the primary healthcare system varied geographically and are associated with professional field, workload, and pressure. Measures that aim to promote the stability of primary care human resource should be considered in the future.