Abstract：Objective To explore the association of household iodized salt consumption with early childhood development (ECD) in children aged 0~35 months in poor rural areas. Methods Children aged 0~35 month in poor rural areas where Integrated Early Childhood Development (IECD) program implemented was enrolled as the participants before initiation of the intervention. The information on household iodized salt consumption was collected by a questionnaire. Child development status was evaluated by Ages & Stages Questionnaires Chinese version (ASQ-C). A mediation analysis was conducted to test whether the effect of consuming iodized salt on child development was mediated by caregiver's mental health and nurturing care practices. Results A total of 2591 children aged 0~35 months were enrolled in the study, of which 59 (2.3%) were from households consuming non-iodized salt. The prevalence of overall suspected developmental delay in children from households consuming non-iodized salt was 62.7%, which was significantly higher than those from households consuming iodized salt (32.5%). Logistic regression analysis showed that the odds ratio of overall suspected development delay in children from households consuming non-iodized salt compared to those from households consuming iodized salt was 1.81 (95%CI: 1.01~3.23). The mediation analysis showed that household consuming non-iodized salt significantly increased the risk of depression in caregivers, reduced the likelihood of having toys and supporting for early learning, and then increased the risk of suspected developmental delay (P<0.05). Conclusion Household consuming iodized salt has a significant protective effect on early childhood development, which is possibly mediated by improving caregiver's mental health and nurturing care practices.
基金资助:联合国儿童基金会项目(0860/A0/05/502 Health & Nutrition Grant)
通讯作者:
王晓莉(xlwang@bjmu.edu.cn)
引用本文:
吴天晨, 石慧峰, 张敬旭, 魏乾伟, 张翠红, 郭素芳, 赵春霞, 王晓莉. 食盐加碘对贫困农村地区0~35月龄儿童早期发展的影响[J]. 中国生育健康杂志, 2022, 33(1): 1-7.
WU Tianchen, SHI Huifeng, ZHANG Jingxu, WEI Qianwei, ZHANG Cuihong, GUO Sufang, ZHAO Chunxia, WANG Xiaoli. Effect of household using iodized salt on early childhood development in children younger than 35 months in poor rural China. Chinese Journal of Reproductive Health, 2022, 33(1): 1-7.
1 Sameroff A.The transactional model of development:how children and contexts shape each other.New York:Wiley,2009. 2 Thompson RA,Nelson CA.Developmental science and the media-early brain development.American Psychologist,2001,56:5-15. 3 Walker SP,Wachs TD,Grantham-McGregor S,et al.Inequality in early childhood:risk and protective factors for early child development.Lancet,2011,378:1325-1338. 4 Black RE,Allen LH,Bhutta ZA,et al.Maternal and child undernutrition 1-maternal and child undernutrition:global and regional exposures and health consequences.Lancet,2008,371:243-260. 5 Zimmermann MB,Jooste PL,Pandav CS.Iodine-deficiency disorders.Lancet,2008,372:1251-1262. 6 UNICEF.Tracking Progress on Child and Maternal Nutrition:A Survival and Development Priority.New York,2009. 7 de Benoist B,McLean E,Andersson M,et al.Iodine deficiency in 2007:Global progress since 2003. Food Nutr Bull,2008,29:195-202. 8 UNICEF.Multiple Indicator Cluster Surveys.Available at:http://mics.unicef.org/Accessed:2017-9-25. 9 Ruel MT,Menon P.Child feeding practices are associated with child nutritional status in Latin America:Innovative uses of the demographic and health surveys.J Nutr,2002,132:1180-1187. 10 Zung WW.A self-rating depression scale.Arch Gen Psychiat,1965,12:63-70. 11 卞晓燕,姚国英,Jane S,等.年龄与发育进程问卷上海市儿童常模及心理测量学特性研究.中华儿科杂志,2010,48:492-496. 12 Austin PC.An introduction to propensity score methods for reducing the effects of confounding in observational studies.Multivar Behav Res,2011,46:399-424. 13 Iacobucci D.Mediation analysis and categorical variables:The final frontier.J Consum Psychol,2012,22:582-594. 14 MacKinnon DP,Cox MG.Commentary on "Mediation analysis and categorical variables:The final frontier" by Dawn Iacobucci.J Consum Psychol,2012,22:600-602. 15 Tofighi D,MacKinnon DP.RMediation:An R package for mediation analysis confidence intervals.Behav Res Methods,2011,43:692-700. 16 Walker SP,Wachs TD,Gardner JM,et al.Child development:risk factors for adverse outcomes in developing countries.Lancet,2007,369:145-157. 17 Tran TD,Hetzel B,Fisher J.Access to iodized salt in 11 low-and lower-middle-income countries:2000 and 2010. Available at:http://www.who.int/bulletin/volumes/94/2/15-160036-ab/zh/Accessed 2017-11-11. 18 Gordon RC,Rose MC,Skeaff SA,et al.Iodine supplementation improves cognition in mildly iodine-deficient children.Am J Clin Nutr,2009,90:1264-1271. 19 Angermayr L,Clar C.Iodine supplementation for preventing iodine deficiency disorders in children.Cochrane Database Syst Rev,2004:Cd003819. 20 Zimmermann MB.The role of iodine in human growth and development.Semin Cell Dev Biol,2011,22:645-652. 21 Henjum S,Lilleengen AM,Aakre I,et al.Suboptimal iodine concentration in breastmilk and inadequate iodine intake among lactating women in Norway.Nutrients,2017,9:643. 22 Zimmermann MB.The impact of iodised salt or iodine supplements on iodine status during pregnancy,lactation and infancy.Public Health Nutr,2007,10:1584-1595. 23 Zimmermann M,Delange F.Iodine supplementation of pregnant women in Europe:a review and recommendations.Eur J Clin Nutr,2004,58:979-984. 24 Mlyniec K,Gawel M,Doboszewska U,et al.Essential elements in depression and anxiety.Part II.Pharmacol Rep,2015,67:187-194. 25 Pachter LM,Auinger P,Palmer R,et al.Do parenting and the home environment,maternal depression,neighborhood,and chronic poverty affect child behavioral problems differently in different racial-ethnic groups?.Pediatrics,2006,117:1329-1338. 26 Lim J,Wood BL,Miller BD,et al.Effects of paternal and maternal depressive symptoms on child internalizing symptoms and asthma disease activity:mediation by interparental negativity and parenting.J Fam Psychol,2011,25:137-146. 27 Lim J,Wood BL,Miller BD.Maternal depression and parenting in relation to child internalizing symptoms and asthma disease activity.J Fam Psychol,2008,22:264-273.
