使用三种不同参考图表对婴幼儿进行生长评估。

Growth assessment in infants and toddlers using three different reference charts.

作者信息

Nash Andrea, Corey Mary, Sherwood Kelly, Secker Donna, Saab Joanne, O'Connor Deborah L

机构信息

Department of Newborn and Developmental Paediatrics, Sunnybrook and Women's College Health Science Centre, 76 Grenville Street, Toronto, Canada.

出版信息

J Pediatr Gastroenterol Nutr. 2005 Mar;40(3):283-8. doi: 10.1097/01.mpg.0000155183.54001.01.

DOI:10.1097/01.mpg.0000155183.54001.01

PMID:15735481

Abstract

OBJECTIVE

To determine if the proportion of children < or =24 months old in a tertiary care facility defined as at risk of undernutrition or overnutrition differs according to different references used for assessment: the Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS) or Tanner-Whitehouse (Tanner) growth charts for weight-for-age and length-for-age.

METHODS

Lengths and weights were measured on infants (207 female, 341 male) aged < or =24 months admitted from or attending clinics in the General Pediatric or Respiratory Medicine Programs at The Hospital for Sick Children, Toronto. Weight-for-age and length-for-age percentiles and percent ideal body weight were electronically computed.

RESULTS

The proportion of all children whose weight-for-age was <3rd percentile (at risk of undernutrition) was greatest using the CDC growth charts (22.5%) compared with the NCHS (15.9%) or Tanner (19.2%) growth charts. Likewise, the proportion of all infants/toddlers with percent ideal body weight <90 (at risk of undernutrition) was greatest using the CDC (32.3%) compared with the NCHS (22.1%) or Tanner (25.9%) growth charts. In contrast, the percentage of children whose percent ideal body weight was > or =110% (at risk of overnutrition) was least using the CDC (18.1%) compared with the NCHS (26.1%) or Tanner (22.4%) growth charts.

CONCLUSION

More children aged < or =24 months will be defined as at risk of undernutrition and fewer at risk of overnutrition when using weight-for-age or percent ideal body weight and the CDC growth charts compared with the NCHS or Tanner growth charts. As a result, requests for a more detailed nutritional assessment for undernutrition will likely follow implementation of the CDC growth charts in a tertiary care setting. As the CDC, NCHS and Tanner growth charts are growth "references" rather than "standards," other than for screening purposes, they should not be used in isolation when assessing growth and nutritional status.

摘要

目的

确定在一家三级医疗机构中，根据不同的评估参考标准（疾病控制与预防中心（CDC）、国家卫生统计中心（NCHS）或用于年龄别体重和年龄别身长的坦纳-怀特豪斯（Tanner）生长曲线），24个月及以下被定义为有营养不良或营养过剩风险的儿童比例是否存在差异。

方法

对多伦多病童医院普通儿科或呼吸内科项目中收治或就诊的24个月及以下婴儿（207名女性，341名男性）进行身长和体重测量。通过电子计算得出年龄别体重和年龄别身长百分位数以及理想体重百分比。

结果

与NCHS（15.9%）或Tanner（19.2%）生长曲线相比，使用CDC生长曲线时，所有年龄别体重低于第3百分位数（有营养不良风险）的儿童比例最高（22.5%）。同样，与NCHS（22.1%）或Tanner（25.9%）生长曲线相比，使用CDC生长曲线时，所有婴儿/幼儿理想体重百分比低于90（有营养不良风险）的比例最高（32.3%）。相比之下，与NCHS（26.1%）或Tanner（22.4%）生长曲线相比，使用CDC生长曲线时，理想体重百分比大于或等于110%（有营养过剩风险）的儿童百分比最低（18.1%）。

结论

与NCHS或Tanner生长曲线相比，使用年龄别体重或理想体重百分比以及CDC生长曲线时，24个月及以下被定义为有营养不良风险的儿童更多，有营养过剩风险的儿童更少。因此，在三级医疗机构实施CDC生长曲线后，可能会有更多关于营养不良的详细营养评估请求。由于CDC、NCHS和Tanner生长曲线是生长“参考标准”而非“标准”，除筛查目的外，在评估生长和营养状况时不应单独使用。