Fierman A H, Dreyer B P, Quinn L, Shulman S, Courtlandt C D, Guzzo R
Department of Pediatrics, New York University School of Medicine, New York 10016.
Pediatrics. 1991 Nov;88(5):918-25.
This study compared the growth of homeless children with National Center for Health Statistics (NCHS) standards and with growth of age-matched domiciled children of similar income level. Homeless children (n = 167) had lower height percentiles when compared with domiciled children (n = 167; P less than .001) and when compared with NCHS standards (P less than .001). The weight-height percentiles of homeless children did not differ from NCHS standards; however, domiciled children had higher weight-heights when compared with the homeless (P less than .001) and with NCHS standards (P less than .001). After controlling via regression analysis for the effects of potentially confounding factors that affect growth, it was found that homeless children from larger families and with single mothers accounted for the lower height percentiles observed. After controlling for confounding factors, domiciled children still had increased weight-height percentiles when compared with the homeless group. Duration of homelessness was not associated with decreased height or weight-height among homeless children. Homeless children in this study exhibited a pattern of stunting without wasting which is characteristic of poor children experiencing moderate, chronic nutritional stress. They exhibited a greater degree of nutritional stress than domiciled children at a similar income level and than that reported in other groups of poor children in the United States. Preexisting social factors in the families of homeless children were important in explaining the observed growth abnormalities. Further exploration of the associations between social characteristics of homeless children and their families and the growth of these children is warranted.
本研究将无家可归儿童的生长情况与美国国家卫生统计中心（NCHS）的标准进行了比较，并与收入水平相似、年龄匹配的有家可归儿童的生长情况进行了对比。无家可归儿童（n = 167）与有家可归儿童（n = 167；P <.001）相比，以及与NCHS标准相比（P <.001），身高百分位数更低。无家可归儿童的体重-身高百分位数与NCHS标准没有差异；然而，有家可归儿童与无家可归儿童相比（P <.001），以及与NCHS标准相比（P <.001），体重-身高更高。在通过回归分析控制了影响生长的潜在混杂因素的影响后，发现来自大家庭且母亲为单身的无家可归儿童导致了观察到的较低身高百分位数。在控制了混杂因素后，有家可归儿童与无家可归组相比，体重-身高百分位数仍然增加。无家可归的持续时间与无家可归儿童身高或体重-身高的降低无关。本研究中的无家可归儿童表现出发育迟缓但无消瘦的模式，这是经历中度慢性营养压力的贫困儿童的特征。他们比收入水平相似的有家可归儿童以及美国其他贫困儿童群体表现出更大程度的营养压力。无家可归儿童家庭中先前存在的社会因素在解释观察到的生长异常方面很重要。有必要进一步探索无家可归儿童及其家庭的社会特征与这些儿童生长之间的关联。
