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[不同胎龄中国新生儿体重/身长、体重指数及体质指数的参考值与生长曲线]

[Reference values and growth curves of weight/length, body mass index, and ponderal index of Chinese newborns of different gestational ages].

作者信息

Zong X N, Li H, Zhang Y Q, Wu H H

机构信息

Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China.

出版信息

Zhonghua Er Ke Za Zhi. 2021 Mar 2;59(3):181-188. doi: 10.3760/cma.j.cn112140-20201130-01063.

Abstract

To establish the reference values and growth curves of weight/length, body mass index, and ponderal index for Chinese newborns with gestational ages of 24 to 42 weeks, in order to provide a reference for the assessment of body proportionality and nutritional status at birth. Cross-sectional study design was applied. From June 2015 to November 2018, a total of 24 375 singleton live birth newborns with gestational ages of 24 to 42 weeks from 13 cities including Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou, Kunming, Tianjin, Shenyang, Changsha, and Shenzhen were selected, excluding those impacting the establishment of the reference values. The generalized additive model for location, scale, and shape (GAMLSS) was employed to establish percentile (P, P, P, P, P, P, P) reference values and growth curves of weight/length, body mass index, and ponderal index for male and female newborns with gestational ages of 24 to 42 weeks. The established growth standards in this study were compared with the standards from the 1988 Chinese data, the INTERGROWTH project, and the USA reference values. A total of 24 375 newborns with 12 264 preterm newborns (7 042 males and 5 222 females) and 12 111 full-term newborns (6 155 males and 5 956 females) were included in this study. The percentile reference values and growth curves of weight/length, body mass index, and ponderal index were obtained for male and female newborns with gestational ages of 24 to 42 weeks. Weight/length of males in all gestational ages at P, P and P was 0 to 0.2 kg/m higher than that of females, and body mass index of males in all gestational ages at the P, P and P was 0.1 to 0.3 kg/m higher than that of females. The established growth curves of weight/length and body mass index at the upper percentile and ponderal index at both upper and lower percentiles were greatly different from those of the 1988 Chinese data, which, for example, reported the difference ranges at P as -1.09 to 0.40 kg/m for weight/length, -1.19 to 0.92 kg/m for body mass index, and -0.64 to 0.81 kg/m for ponderal index. The established weight/length curves were generally consistent with the reference values from the INTERGROWTH project with a difference of -0.17 to 0.20 kg/m at P, while being 0.02 to 0.40 kg/m lower at P and 0.13 to 0.41 kg/m higher at P than that of the INTERGROWTH reference values at gestational ages of ≤32 weeks. The established body mass index curves differed from that of the USA reference values with a difference of -0.47 to 0.17 kg/m at P, while being 0.53 to 1.10 kg/m lower at gestational ages of ≥37 weeks but 0.17 to 0.45 kg/m higher at gestational ages of ≤28 weeks than that of the USA reference values at P. The establishment of the new standardized growth reference values of weight/length, body mass index, and ponderal index for Chinese newborns by different gestational ages are useful for clinical practice and scientific research.

摘要

为建立孕24至42周中国新生儿体重/身长、体重指数和 ponderal 指数的参考值及生长曲线,为评估出生时的身体比例和营养状况提供参考。采用横断面研究设计。2015年6月至2018年11月,从北京、哈尔滨、西安、上海、南京、武汉、广州、福州、昆明、天津、沈阳、长沙和深圳13个城市选取了24375例孕24至42周的单胎活产新生儿,排除影响参考值建立的因素。采用位置、尺度和形状的广义相加模型(GAMLSS)建立孕24至42周男、女新生儿体重/身长、体重指数和 ponderal 指数的百分位数(P1、P3、P5、P10、P25、P50、P75)参考值及生长曲线。将本研究建立的生长标准与1988年中国数据、INTERGROWTH项目标准和美国参考值进行比较。本研究共纳入24375例新生儿,其中12264例早产儿(男7042例,女5222例)和12111例足月儿(男6155例,女5956例)。获得了孕24至42周男、女新生儿体重/身长、体重指数和 ponderal 指数的百分位数参考值及生长曲线。各孕周男性的体重/身长在P1、P3和P5百分位数时比女性高0至0.2kg/m,各孕周男性的体重指数在P1、P3和P5百分位数时比女性高0.1至0.3kg/m。本研究建立的体重/身长和体重指数的较高百分位数生长曲线以及ponderal指数的上下百分位数生长曲线与1988年中国数据有很大差异,例如,1988年中国数据报告P5百分位数时体重/身长的差异范围为-1.09至0.40kg/m,体重指数为-1.19至0.92kg/m,ponderal指数为-0.64至0.81kg/m。本研究建立的体重/身长曲线与INTERGROWTH项目参考值总体一致,P5百分位数时差异为-0.17至0.20kg/m,孕周≤32周时,P1百分位数比INTERGROWTH参考值低0.02至0.40kg/m,P97百分位数比INTERGROWTH参考值高0.13至0.41kg/m。本研究建立的体重指数曲线与美国参考值不同,P5百分位数时差异为-0.47至0.17kg/m,孕周≥37周时比美国参考值低0.53至1.10kg/m,但孕周≤28周时比美国参考值高0.17至0.45kg/m。按不同孕周建立中国新生儿体重/身长、体重指数和 ponderal 指数的新的标准化生长参考值,对临床实践和科研具有重要意义。

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