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小于胎龄儿最终身高测定的预测因素

Prediction factors in the determination of final height in subjects born small for gestational age.

作者信息

Leger J, Limoni C, Collin D, Czernichow P

机构信息

Pediatric endocrinology and diabetes unit, Hôpital Robert Debré, Paris, France.

出版信息

Pediatr Res. 1998 Jun;43(6):808-12. doi: 10.1203/00006450-199806000-00015.

Abstract

The aim of this study was to identify factors predictive of individual final height (FH) in subjects born small for gestational age (SGA). All full-term singleton subjects born SGA (birth weight and/or length <3rd percentile) during the period 1971-1978, matched with appropriate birth weight for gestational age (AGA) subjects (birth weight between 25th and 75th percentile) were followed from birth to FH and evaluated before puberty at a mean age +/- SD of 6.1 +/- 0.7 y and after puberty at a mean age of 20.8 +/- 2.0 y (subjects born SGA, n = 213; born AGA, n = 272). When adjusted for target height, a significant deficit in final height (p < 0.0001) was found in SGA as compared with AGA subjects for both male subjects (-3.99 cm with 95% confidence interval from -5.6 to -2.4) and female subjects (-3.64 cm with 95% confidence interval from -5.0 to -2.3), with 13.6% of subjects in the SGA population presenting short final stature. In a multiple regression analysis, target height and studied group (SGA or AGA) were found to be the strongest predictors of individual FH (p < 0.0001, r2 = 0.35 for male subjects, p < 0.0001, r = 0.40 for female subjects). For SGA subjects and according to a multiple stepwise linear regression model, 31% of the variability of individual FH [SD score (SDS)] and 58% of the variability of individual height gain SDS could be explained at birth from mother's height, father's height, and birth length SDS. No other variables were found to be predictive such as sex, gestational age (from 37 to 42 wk), birth weight SDS, ponderal index at birth, or risk factors during pregnancy associated with intrauterine growth retardation such as pregnancy-induced hypertension, smoking, or a history of SGA in offspring. Although a significant increase of body mass index SDS was documented before and after puberty in SGA subjects, puberty was not found to have any influence on growth outcome.

摘要

本研究的目的是确定小于胎龄儿(SGA)个体最终身高(FH)的预测因素。对1971年至1978年期间出生的所有足月单胎SGA(出生体重和/或身长<第3百分位数)进行研究,并与胎龄适当的出生体重正常(AGA)儿(出生体重在第25至75百分位数之间)进行匹配,从出生追踪至最终身高,并在青春期前平均年龄±标准差为6.1±0.7岁时以及青春期后平均年龄20.8±2.0岁时进行评估(SGA出生儿,n = 213;AGA出生儿,n = 272)。在根据目标身高进行调整后,发现SGA男性与AGA男性相比,最终身高存在显著差异(p < 0.0001)(-3.99 cm,95%置信区间为-5.6至-2.4),SGA女性与AGA女性相比,最终身高也存在显著差异(-3.64 cm,95%置信区间为-5.0至-2.3),SGA人群中有13.6%的个体最终身高矮小。在多元回归分析中,发现目标身高和研究组(SGA或AGA)是个体最终身高的最强预测因素(男性,p < 0.0001,r2 = 0.35;女性,p < 0.0001,r = 0.40)。对于SGA个体,根据多元逐步线性回归模型,个体最终身高[标准差评分(SDS)]的31%变异性以及个体身高增长SDS的58%变异性在出生时可由母亲身高、父亲身高和出生身长SDS解释。未发现其他变量具有预测性,如性别、胎龄(37至42周)、出生体重SDS、出生时的 ponderal指数或孕期与宫内生长迟缓相关的危险因素,如妊娠高血压、吸烟或子代有SGA病史。尽管记录显示SGA个体在青春期前后体重指数SDS显著增加,但未发现青春期对生长结局有任何影响。

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