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人类生长与发育

Human Growth and Development

作者信息

Balasundaram Palanikumar, Avulakunta Indirapriya Darshini

机构信息

University of Illinois College Medicine of Rockford, & Javon Bea Hospital, Mercy Health System, IL

Montefiore Medical Center

Abstract

In the context of childhood development, growth is defined as an irreversible constant increase in size, and development is defined as growth in psychomotor capacity. Both processes are highly dependent on genetic, nutritional, and environmental factors.  Evaluation of growth and development is a crucial element in the physical examination of a patient. Good working knowledge and the skills to evaluate growth and development are necessary for any patient's diagnostic workup. The early recognition of growth or developmental failure helps effective intervention in managing a patient's problem. 1. Fetal health issues can have detrimental effects on postnatal growth. One-third of neonates with intrauterine growth retardation might have curtailed postnatal growth. Good perinatal care is essential in promoting fetal health and, indirectly, postnatal growth. 2. The postnatal growth and development process happens together but at different rates. The growth occurs by discontinuous saltatory spurts with a stagnant background. There are 5 significant phases in human growth and development, 1. Infancy (neonate and up to 1 year age). 2. Toddler (1 to 5 years of age). 3. Childhood (3 to 11 years old) - early childhood is from 3 to 8 years old, and middle childhood is from 9 to 11 years old. . 4. Adolescence or teenage (from 12 to 18 years old). 5. Adulthood. The growth and development are positively influenced by factors like parental health and genetic composition, even before conception. 1. Genetic factors play a primary role in growth and development. The genetic factors influencing height are substantial in the adolescence phase. A large longitudinal cohort study of 7755 Dutch twin pairs has suggested that the additive genetic factors predominantly explained the phenotypic correlations across the ages for height and body mass index. . 2. Fetal health has a highly influential role in achieving growth and development. Any stimulus or insult during fetal development causes developmental adaptations that permanently change the latter part of life. 3. After birth, the environmental factors may exert either a beneficial or detrimental effect on growth. 4.  Children of higher socioeconomic classes are taller than children of the same age and sex in the lower socioeconomic groups. Urbanization has positively influenced growth. The secular trend is observed in growth, where the kids grow taller and mature more rapidly than the previous generation. This secular trend is observed significantly in developed countries like North America. Higher family education levels have a positive impact on growth. The inadequate emotional support and developmental stimulus, including language training, might cause deterioration in growth and development. . The human-made environment influences human growth and development significantly. Ongoing studies have proven the relationship between pollutants in sexual maturation, obesity, and thyroid function. The excess lead exposure antenatally is significantly associated with low birth weight. Noise pollution due to transportation sources is also associated with reduced prenatal growth. .  . 1. Malnutrition plays a detrimental role in the process of growth and development. . 2. Deficiencies of trace minerals can affect growth and development. Iron deficiency usually affects psychomotor development and does not affect growth. Zinc deficiency might cause growth retardation and developmental delay. Selenium, iodine, manganese, and copper also play a significant role. . 3. Growth faltering or rapid weight gain in early childhood influences health later in life. The diet in early childhood is strongly associated with the likelihood of obesity later in life. 'Early Protein Hypothesis' shows that lowering the protein supply during infancy helps achieve normal growth and reduce obesity in early childhood. This concept of the early protein hypothesis helps improve children's food products. . 5. Genetic and environmental factors influence the growth and development in a perplexing interrelated pathway. Genetic and environmental risk factors are not mutually exclusive. Plasticity is the potential of a specific genotype to bring out diversified phenotypes in response to diverse environmental factors. The developmental plasticity can happen from embryonic to adolescence and be passed on to the next generation. . 6. Exposure to adverse experiences might hinder development. Profound neglect during early childhood can impair development. Children adopted before 6 months of age have similar development when compared to their non-adoptive siblings. If children are adopted after 6 months, they have a high risk of cognition deficits, behavioral issues, autism, and hyperactivity. Early intervention for children with adverse experiences is the pillar of healthy development.

摘要

在儿童发育的背景下,生长被定义为大小不可逆的持续增加,发育被定义为心理运动能力的增长。这两个过程都高度依赖于遗传、营养和环境因素。生长和发育的评估是患者体格检查的关键要素。对于任何患者的诊断检查,具备良好的实用知识和评估生长与发育的技能是必要的。早期识别生长或发育迟缓有助于对患者问题进行有效干预。1. 胎儿健康问题可能对出生后的生长产生不利影响。三分之一的宫内生长受限新生儿可能出生后生长受限。良好的围产期护理对于促进胎儿健康以及间接促进出生后生长至关重要。2. 出生后的生长和发育过程同时进行,但速度不同。生长以不连续的跳跃式突增发生,伴有停滞期。人类生长和发育有5个重要阶段,1. 婴儿期(新生儿至1岁)。2. 幼儿期(1至5岁)。3. 儿童期(3至11岁)——幼儿期为3至8岁,童年中期为9至11岁。4. 青春期或青少年期(12至18岁)。5. 成年期。甚至在受孕前,父母健康和基因组成等因素就对生长和发育有积极影响。1. 遗传因素在生长和发育中起主要作用。影响身高的遗传因素在青春期阶段作用显著。一项对7755对荷兰双胞胎的大型纵向队列研究表明,加性遗传因素主要解释了身高和体重指数在各年龄段的表型相关性。2. 胎儿健康在实现生长和发育方面具有高度影响力。胎儿发育期间的任何刺激或损伤都会导致发育适应,从而永久改变生命后期。3. 出生后,环境因素可能对生长产生有益或有害影响。4. 社会经济阶层较高的儿童比社会经济阶层较低的同年龄、同性别的儿童更高。城市化对生长有积极影响。在生长方面观察到长期趋势,即孩子们比上一代长得更高且成熟得更快。这种长期趋势在北美等发达国家尤为明显。较高的家庭教育水平对生长有积极影响。包括语言训练在内的情感支持和发育刺激不足可能导致生长和发育恶化。人造环境对人类生长和发育有重大影响。正在进行的研究已证实污染物与性成熟、肥胖和甲状腺功能之间的关系。产前铅暴露过多与低出生体重显著相关。交通源产生的噪音污染也与产前生长减少有关。1. 营养不良在生长和发育过程中起有害作用。2. 微量矿物质缺乏会影响生长和发育。缺铁通常影响心理运动发育而不影响生长。缺锌可能导致生长迟缓及发育延迟。硒、碘、锰和铜也起重要作用。3. 幼儿期生长停滞或体重快速增加会影响日后健康。幼儿期饮食与日后肥胖的可能性密切相关。“早期蛋白质假说”表明,婴儿期降低蛋白质供应有助于实现正常生长并减少幼儿期肥胖。早期蛋白质假说这一概念有助于改进儿童食品。5. 遗传和环境因素以复杂的相互关联途径影响生长和发育。遗传和环境风险因素并非相互排斥。可塑性是特定基因型在应对不同环境因素时展现出多样化表型的潜力。发育可塑性可从胚胎期到青春期发生,并传递给下一代。6. 接触不良经历可能阻碍发育。幼儿期的严重忽视会损害发育。6个月前被收养的儿童与非收养的兄弟姐妹相比发育相似。如果儿童在6个月后被收养,他们有认知缺陷、行为问题、自闭症和多动症的高风险。对有不良经历的儿童进行早期干预是健康发育的支柱。

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