足月儿出生后的体重减轻：什么是正常情况，生长图表考虑到这一点了吗？
Postnatal weight loss in term infants: what is normal and do growth charts allow for it?
作者信息
Wright C M, Parkinson K N
机构信息
Department of Child Health, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
出版信息
Arch Dis Child Fetal Neonatal Ed. 2004 May;89(3):F254-7. doi: 10.1136/adc.2003.026906.
BACKGROUND
Although it is a well known phenomenon, limited normative data on neonatal weight loss and subsequent gain are available, making it hard to assess individual children with prolonged weight loss.
OBJECTIVE
To establish, using data from a large prospective population based cohort study, norms and limits for postnatal weight loss and its impact on current growth reference charts.
METHOD
A cohort of 961 term infants were recruited at birth and followed using parental questionnaires and community nursing returns. Routine weights were collected for half the cohort at 5 days and for all at 12 days and 6 weeks.
RESULTS
Less weight loss was seen than the 3-6% suggested by previous studies, but one in five infants had not regained their birth weight by 12 days. Those lightest at birth showed least weight loss. Twenty six (3%) children had more than 10% weight loss, but none showed evidence of major organic disease. Actual weights in the first fortnight are half to one centile space lower than growth charts suggest, while birthweight centiles for children born at 37 weeks were two centile spaces lower.
CONCLUSIONS
Neonatal weight loss is brief, with few children remaining more than 10% below birth weight after 5 days. Growth charts are misleading in the first 2 weeks, because they make no allowance for neonatal weight loss.
背景
尽管这是一个众所周知的现象，但关于新生儿体重减轻及随后体重增加的规范数据有限，这使得评估体重减轻时间延长的个体儿童变得困难。
目的
利用一项大型前瞻性人群队列研究的数据，确定出生后体重减轻的规范和限度及其对当前生长参考图表的影响。
方法
招募了961名足月儿，出生时进行登记，并通过家长问卷和社区护理回访进行跟踪。对队列中的一半儿童在5天时测量常规体重，对所有儿童在12天和6周时测量。
结果
观察到的体重减轻比先前研究提出的3%-6%要少，但五分之一的婴儿在12天时仍未恢复到出生体重。出生时体重最轻的婴儿体重减轻最少。26名（3%）儿童体重减轻超过10%，但均未显示出重大器质性疾病的迹象。头两周的实际体重比生长图表显示的低半个至一个百分位区间，而37周出生儿童的出生体重百分位比图表低两个百分位区间。
结论
新生儿体重减轻时间短暂，5天后很少有儿童体重比出生体重低超过10%。生长图表在前两周具有误导性，因为它们没有考虑到新生儿体重减轻的情况。
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