Estado nutricional de ferro e vitamina A em crianças menores de cinco anos atendidas em creches municipais da área urbana de Juiz de Fora- MG

Abstract

The objective of the study was to evaluate the nutritional status of iron and vitamin A in children under five years of age attended at municipal daycare centers in Juiz de Fora - MG; to identify the prevalence and factors associated with anemia in children and the factors associated with serum retinol levels in anemic children. This is a cross-sectional study with a sample of 762 children enrolled full-time in all 15 daycare centers in the selected regions. For hemoglobin determination, a portable hemoglobinometer was used, and 11 g / dL as the cutoff point for the diagnosis of anemia. Among the anemic children, a sample of 180 children was randomly selected through the simple random method to be submitted to the serum retinol test, considered as a retinol cut-off point <20 μg / L (deficient), and = 20 μg / L (borderline). A questionnaire was applied to those responsible for all 762 children, containing socioeconomic information, maternal characteristics, breastfeeding, complementary feeding, and individual characteristics of the child. Anthropometric measures of weight and height were used to assess nutritional status, the 24-hour recall and the food record were the instruments used to assess food consumption. Logistic and linear regression analysis were used to verify the factors associated with anemia and serum retinol, through univariate regression analysis, and then in the second step, hierarchical analysis of the variables in blocks was applied. The prevalence of anemia found was 39.2%, maternal age was inversely associated with the outcome, and the number of pregnancies showed a directly proportional association (β = -0.48, 95% CI = 0.91-0.99; β = 0.19, 95% CI = 1.02-1.43, respectively), low weight (OR = 2.51; 95% CI = 1.12-5.63) and weight / age (β = -3 , 98; 95% CI = 0.01-0.90) also associated with anemia. Regarding serum retinol, no anemic children evaluated had vitamin A deficiency, however, 38.9% had borderline values for deficiency. The variables associated with serum retinol levels were: duration of pregnancy (β = 0.008; 95% CI = 0.001 / 0.015), use of ferrous compounds (β = 0.050; 95% CI = 0.003 / 0.097) and adequate calcium intake (β = 0.043; 95% CI = 0.007 / 0.079). It is concluded that anemia in daycare centers in the studied regions is considered a moderate public health problem. The variables associated with anemia are related to maternal characteristics and individual characteristics of children, being intermediate and proximal variables to the outcome. In addition, no anemic children in the daycare centers studied showed vitamin A deficiency, and the variables associated with serum retinol levels in anemic children are related to the individual characteristics of the children, being variables proximal to the outcome.