Ahmed M L, Allen A D, Sharma A, Macfarlane J A, Dunger D B
Department of Paediatrics, John Radcliffe Hospital, Oxford.
Arch Dis Child. 1993 Sep;69(3):361-5. doi: 10.1136/adc.69.3.361.
The Oxford district growth screening programme was established in 1988 as a community based survey of the heights of children at 3 and 4.5 years of age in a district of 550,000 people. The current birthrate is 7500 births/year and over the first three years of the study 20,338 children were screened in the community; the ascertainment ranged from 61-73.9% of the total expected. Mean height SD scores were significantly greater than the British standards; mean SD scores for boys and girls were 0.33 and 0.35 respectively at age 3, and 0.20 and 0.26 at 4.5 years. Altogether 260 (1.3%) of the total cohort were found to have heights < or = -2SD scores. The mean growth velocity of 2742 children measured at 3 and 4.5 years of age was similar to that of the national standards, 7.14 cm/year in boys and 7.21 cm/year in girls. Follow up data was available from 149 children whose heights were confirmed to be < or = -2SD scores. Of these 69 were already under the care of paediatricians. Thus far diagnoses in the 149 have included growth hormone deficiency (n = 2), Turner's syndrome (n = 2), Noonan's syndrome (n = 4), and emotional deprivation (n = 1). Ways in which ascertainment and detection of treatable causes of short stature could be improved are discussed and it is concluded that community growth screening is a useful part of the child health surveillance programme.
牛津地区生长发育筛查项目始于1988年，是一项针对一个拥有55万人口地区中3岁和4.5岁儿童身高的社区调查。当前出生率为每年7500例分娩，在研究的前三年里，该社区对20338名儿童进行了筛查；确诊率在预期总数的61%-73.9%之间。平均身高标准差分数显著高于英国标准；3岁时男孩和女孩的平均标准差分数分别为0.33和0.35，4.5岁时分别为0.20和0.26。在整个队列中，共发现260名（1.3%）儿童的身高低于或等于-2个标准差分数。对2742名3岁和4.5岁儿童测量的平均生长速度与国家标准相似，男孩为每年7.14厘米，女孩为每年7.21厘米。有149名身高经确认低于或等于-2个标准差分数的儿童有随访数据。其中69名儿童已在儿科医生的照料之下。到目前为止，这149名儿童的诊断结果包括生长激素缺乏症（2例）、特纳综合征（2例）、努南综合征（4例）和情感剥夺（1例）。文中讨论了如何改进矮小症可治疗病因的确诊和检测方法，并得出结论：社区生长发育筛查是儿童健康监测项目的一个有益组成部分。
