de Onis Mercedes, Wijnhoven Trudy M A, Onyango Adelheid W
Department of Nutrition, World Health Organization, 1211 Geneva 27, Switzerland.
J Pediatr. 2004 Apr;144(4):461-5. doi: 10.1016/j.jpeds.2003.12.034.
To describe child growth monitoring practices worldwide in preparation for the construction and application of a new international growth reference.
A questionnaire was sent to Ministries of Health in 202 countries requesting information on growth charts used in national programs, reference populations, classification systems, problems encountered, and actions taken against growth faltering. Countries also provided hard copies of charts in current use. This information was entered and analyzed in Microsoft Access.
Responses were received from 178 (88%) countries, 154 of which included growth charts (n=806). Two thirds of the charts covered preschool age. All countries used weight-for-age, over half relying on this index alone. The reference most commonly used (68%) was the National Center for Health Statistics/World Health Organization population, with regional variations, where most European countries used local standards. Sixty-three percent of charts classified child growth on percentiles, whereas about one fifth used z scores. Problems reported were both conceptual (eg, interpreting growth trajectories) and practical (eg, lack of equipment).
The survey demonstrates that growth charts are used universally in pediatric care. The information gathered on current use and interpretation of growth charts provides important guidance for constructing and applying the new reference.
描述全球儿童生长监测实践，为构建和应用新的国际生长参考标准做准备。
向202个国家的卫生部发送了一份调查问卷，询问有关国家项目中使用的生长图表、参考人群、分类系统、遇到的问题以及针对生长发育迟缓采取的措施等信息。各国还提供了现行使用图表的硬拷贝。这些信息被录入Microsoft Access并进行分析。
收到了178个（88%）国家的回复，其中154个国家提供了生长图表（n = 806）。三分之二的图表涵盖学龄前儿童。所有国家都使用年龄别体重指标，超过半数国家仅依赖这一指标。最常用的参考标准（68%）是美国国家卫生统计中心/世界卫生组织的人群标准，存在地区差异，大多数欧洲国家使用当地标准。63%的图表根据百分位数对儿童生长情况进行分类，约五分之一的图表使用z评分。报告的问题既有概念性的（如解读生长轨迹），也有实际操作方面的（如设备短缺）。
该调查表明生长图表在儿科护理中被普遍使用。收集到的关于生长图表现行使用和解读的信息为构建和应用新的参考标准提供了重要指导。
