Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
BMC Pediatr. 2024 Oct 11;24(1):649. doi: 10.1186/s12887-024-05126-x.
Growth references play a crucial role in the screening, evaluation, and surveillance of children, aiding in the early identification of the requirement for diverse growth-promoting interventions. Variations in human growth across distinct ethnic cohorts arise from genetic disparities, lifestyle variances, nutritional diversity, and diverse social and environmental contexts. Consequently, the selection of growth references markedly influences the prevalence of developmental disorders and nutritional imbalances in children. The study aims to assess the growth percentile of children in the north-east of Iran and establish population-specific reference charts for length, weight, and head circumference spanning from birth to 24 months.
This cross-sectional population-based research conducted in the north-east of Iran, from 2016 to 2023. The Data extracted from the electronic health records of Mashhad University of Medical Sciences. All apparently healthy children aged from birth to 24 months who were measured at least once by health staff at the ages of birth,1,2,4,6,7,9,12,15,18,24 months were included. The target population of the study were 479,089 children (96.21%), encompassing 233,565 girls (48.75%) and 245,524 boys (51.25%). Gender-specific percentile curves for length, weight, and head circumference concerning age, as well as weight concerning length, were derived using the GAMLSS approach.
From the anthropometric information of 479,089 children (245,524 boys and 233,565 girls), growth charts were constructed. In comparison to the standard WHO chart, Iranian neonates displayed lower weight across all percentiles during the first month after birth, exhibited decreased head circumference at the 3rd percentile, and boys showed reduced length across all percentiles. After this age, Iranian children demonstrated increased weight, length, and head circumference.
This research introduces the inaugural large-scale endeavor for indigenous reference charts. Through the noted distinctions from the international reference, the utilization of this novel resource offers the potential to enhance the surveillance of children's growth within the area. Moreover, by accurately assessing growth anomalies such as underweight, stunting, and wasting, it expands the domain of impactful policies in this sphere. Simultaneously, it enables the exploration of the secular trend of children's growth in the forthcoming years.
生长参考资料在儿童的筛查、评估和监测中起着至关重要的作用，有助于早期发现需要进行各种促进生长的干预措施。不同种族群体的人类生长差异源于遗传差异、生活方式差异、营养多样性以及不同的社会和环境背景。因此，生长参考资料的选择显著影响儿童发育障碍和营养失衡的流行率。本研究旨在评估伊朗东北部儿童的生长百分位数，并建立特定于人群的出生至 24 个月的长度、体重和头围参考图表。
这是一项在伊朗东北部进行的横断面人群研究，时间跨度为 2016 年至 2023 年。数据来自马什哈德医科大学的电子健康记录。所有出生至 24 个月、至少由卫生人员在出生、1、2、4、6、7、9、12、15、18、24 个月时测量过的明显健康儿童均被纳入研究。本研究的目标人群为 479089 名儿童（96.21%），其中女孩 233565 名（48.75%），男孩 245524 名（51.25%）。使用 GAMLSS 方法得出了关于年龄的长度、体重和头围的性别特异性百分位数曲线，以及关于长度的体重百分位数曲线。
从 479089 名儿童（245524 名男孩和 233565 名女孩）的人体测量信息中，构建了生长图表。与世界卫生组织标准图表相比，伊朗新生儿在出生后第一个月的所有百分位均显示体重较低，第 3 百分位的头围较小，所有百分位的男孩长度较小。在此年龄之后，伊朗儿童的体重、长度和头围增加。
本研究首次开展了大规模的本土参考图表研究。通过与国际参考资料的差异，使用这一新资源有潜力提高该地区儿童生长监测的水平。此外，通过准确评估体重不足、发育迟缓、消瘦等生长异常，可以扩大该领域有影响力政策的范围。同时，它还可以探索未来几年儿童生长的长期趋势。
