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目的调查山东省3岁以下儿童维生素D补充剂的应用现状,分析其影响因素。方法选取2010年11月-2011年1月来预防接种门诊进行计划免疫与健康保健的儿童945人,在知情同意的情况下选择家长愿意配合者903人作为调查对象。采用自制的调查问卷对儿童抚养人进行维生素D补充剂应用情况的调查。结果山东省婴幼儿维生素D补充剂的应用率为79.6%(719/903例),开始添加时间与停用时间分别是生后30.0(30.0)d、9.0(7.0)个月,应用剂量为60.0～700.0 IU.d-1,出生1周内、≥1～2周与>2～4周开始添加维生素D补充剂的儿童分别占1.9%(12/639例)、3.1%(20/639例)与54.0%(345/639例);76.2%(369/484例)的婴儿1岁以内停用维生素D补充剂,≥1～2岁停用者占17.4%(84/484例),>2～3岁停用者占6.4%(31/484例);不同地区、年龄、喂养方式、居住环境、出生体质量、父母受教育程度以及家庭收入水平的婴幼儿,维生素D补充剂应用率的差异均有统计学意义。多因素Logistic回归分析发现年龄、喂养方式、出生体质量、家庭收入水平和母亲文化程度等是影响维生素D补充剂应用的因素(OR=0.745、1.482、0.614、0.658、1.913,Pa<0.05)。结论维生素D补充剂在山东省婴幼儿中应用普遍,但不规范,不符合近年来国内外维生素D补充剂应用指南的要求。年龄、出生体质量、喂养方式等多种因素影响维生素D补充剂的应用状况。
Objective To investigate the status of vitamin D supplementation in children under 3 years of age in Shandong Province and analyze the influencing factors. Methods A total of 945 children were enrolled in the outpatient immunization program from November 2010 to January 2011, and 903 parents were expected to cooperate with informed consent. A self-made questionnaire was used to investigate the use of vitamin D supplements in child-care workers. Results The application rate of vitamin D supplementation in infants and young children in Shandong Province was 79.6% (719/903 cases). The starting time and discontinuation time were 30.0 (30.0) d, 9.0 (7.0) months after birth and 60.0 ~ 700.0 IU.d-1, 1.9% (12/639), 3.1% (20/639) children with vitamin D supplementation ≥1 ~ 2 weeks and> 2-4 weeks respectively, ) And 54.0% (345/639). 76.2% (369/484) of infants discontinued vitamin D supplementation within 1 year of age, 17.4% (84/484) of patients aged 1-2 years and> 6.4% (31/484) were disabled at 2 to 3 years of age. The rate of vitamin D supplementation in infants and young children with different regions, ages, feeding patterns, living environment, birth weight, parents’ education and family income The differences were statistically significant. Multivariate Logistic regression analysis found that age, mode of feeding, birth weight, family income and mother’s educational level were the factors influencing the use of vitamin D supplementation (OR = 0.745,1.482,0.614,0.658,1.913, Pa <0.05). Conclusion Vitamin D supplementation is common in infants and young children in Shandong Province, but it is not standardized and does not meet the requirements of the application guidelines of vitamin D supplements at home and abroad in recent years. Age, birth weight, feeding methods and other factors affect the application of vitamin D supplementation.