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中国0～9月龄胃肠不适婴儿功能性胃肠病的患病率及影响因素：一项多中心横断面调查研究

Prevalence and Influencing Factors of Functional Gastrointestinal Disorders Among Infants Aged 0 to 9 Months With Gastrointestinal Discomfort in China: A Multicenter Cross-Sectional Survey

    摘要
  • 摘要:
    目的 调查功能性胃肠病在中国不同城市0～9月龄胃肠不适婴儿中的发病情况，并分析相关影响因素。
    方法 采用多中心横断面调查研究的方法，参考婴幼儿功能性胃肠病罗马Ⅳ诊断性问卷并结合已发表的文献设计调查问卷，收集中国东中西部14座城市17家医院0～9月龄胃肠不适婴儿的信息，主要包括家庭基本情况、婴儿出生史、喂养史、胃肠不适症状的类型及频率等，并采用logistic回归进行影响因素分析。
    结果 共纳入0～9月龄胃肠不适婴儿2528例，其中男婴1315例（52.02%），女婴1213例（47.98%）。在受调查的婴儿中，诊断功能性胃肠病者占72.55%，男女患病率差异无统计学意义（P=0.397），其中反流患病率最高，为39.83%。反流、腹绞痛随月龄增加患病率逐渐降低，而排便困难及功能性便秘随月龄增加患病率逐渐增高；单种症状患病率为57.48%，两种或两种以上症状者约为15%，0～3月龄婴儿有两种及以上症状的比例最高（22.02%），而6～9月龄婴儿以单一症状为主（65.96%）。单因素分析结果显示，不同地区、父母学历、家庭人均月收入、患儿日龄、出生胎龄、纯母乳喂养时间以及是否使用益生菌与功能性胃肠病的发生有关（均P<0.05），logistic回归分析结果显示：西部地区〔比值比（odds ratio, OR）=0.407，95%置信区间（confidence interval, CI）：0.324～0.510〕、使用益生菌（OR=0.69，95%CI：0.560～0.847）、出生胎龄（OR=0.914，95%CI：0.837～0.998）以及纯母乳喂养时间>4 个月（OR=0.75，95%CI：0.595～0.946）是影响功能性胃肠病发生的显著因素（均P<0.05）。
    结论 功能性胃肠病在0～9月龄胃肠不适婴儿中较为常见，其发生与地区分布、益生菌使用、出生胎龄及纯母乳喂养时间存在关联，加强护理和喂养知识的指导，如维持肠道菌群平衡、提倡母乳喂养等可能有助于预防婴儿功能性胃肠病的发生。

     

    Abstract:
    Objective To determine the prevalence of functional gastrointestinal disorders (FGIDs) in infants aged 0-9 months with gastrointestinal (GI) discomfort in different cities in China, and to investigate the associated influencing factors.
    Methods A multicenter cross-sectional survey was conducted. The questionnaire was developed based on the Rome Ⅳ Diagnostic Questionnaire for FGIDs in Neonates and Toddlers and published literature. Data were collected from infants aged 0-9 months with GI discomfort at 17 hospitals across 14 cities in eastern, central, and western China. Information on family demographics, neonatal records, feeding history, types and frequency of GI symptoms was collected. Logistic regression was performed to explore factors associated with FGIDs.
    Results A total of 2528 infants aged 0-9 months with GI discomfort were enrolled, with 1315 males (52.02%) and 1213 females (47.98%). Among the surveyed infants, 72.55% were diagnosed with FGIDs, with no statistically significant difference in prevalence between male and female infants (P = 0.397). Regurgitation, with a prevalence of 39.83%, was the most common FGID. The prevalence of regurgitation and colic in infants decreased with increasing age, while the prevalence of dyschezia and functional constipation increased with increasing age. The prevalence of a single symptom was 57.48%, and approximately 15% of infants presented with 2 or more symptoms. The proportion of those presenting with 2 or more symptoms was the highest in infants aged 0-3 months (22.02%), whereas infants aged 6 to 9 months predominantly presented with a single symptom (65.96%). Univariate logistic regression identified significant associations between FGIDs and the geographic region, parental educational attainment, monthly per capita household income, infant age in days, gestational age at birth, duration of exclusive breastfeeding, and probiotic use (all P < 0.05). Logistic regression analysis results showed that residing in the western region (odds ratio OR = 0.407, 95% CI: 0.324-0.510), probiotic use (OR = 0.69, 95% CI: 0.560-0.847), gestational age at birth (OR = 0.914, 95% CI: 0.837-0.998), and the duration of exclusive breastfeeding > 4 months (OR = 0.75, 95% CI: 0.595-0.946) were significant factors influencing the occurrence of FGIDs (all P < 0.05).
    Conclusion FGIDs are highly prevalent among infants aged 0-9 months with gastrointestinal symptoms in China. Their occurrence is linked to geographic region, probiotic use, gestational age, and breastfeeding duration. Future studies should focus on whether improved feeding guidance and breastfeeding promotion can help prevent FGIDs.

     

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