极低出生体重6胞胎中4例0~6岁体格生长监测及分析

目的评价极低出生体重6胞胎中存活的4例0~6岁以来的体格生长情况。 方法监测1998-12-23在中国医科大学盛京医院出生的6胞胎中存活的4例小儿的体格生长情况并给予早期干预。 结果6胞胎出生时身长、体重均低于同胎龄儿标准,为小于胎龄儿。存活的4例小儿体重于生后15岁、身高于生后3岁达正常同龄儿的均值。 结论4例6胞胎极低出生体重儿在系统保健监测情况下,生后2~3年内可表现出良好的追赶生长趋势,体格生长各指标均在正常范围内。     

杭州地区不同出生体质量小儿早期体格生长水平调查

目的 通过不同出生体质量小儿早期体格生长水平的调查、分析与比较，了解小于胎龄儿（SGA）、大于胎龄儿（LGA）和适于胎龄儿（AGA）生命早期生长发育的规律。方法 通过新生儿筛查中心，对浙江省杭州地区2000、2004、2005年出生的38898名新生儿进行调查，随机对其中794名新生儿进行随访，获得当地测量的该年龄时段体质量、身高的体检资料，并计算BMI及Z值。结果 2000、2004、2005年SGA的发生率为1．5％、2．0％和2．3％，LGA的发生率为4．7％、5．2％和4．2％。12～30月龄LGA组体质量、身长和BMI值均为3组之最，其次是AGA组，SGA组处于最低水平。72～78月龄LGA组体质量仍处于领先水平，SGA组身高、BMI追赶上余2组。结论 宫内生长与儿童早期生长密切相关，应针对不同出生体质量儿合理喂养，进行早期生长监测和干预。     

2005年中国九市七岁以下儿童体格发育调查

目的了解和掌握我国儿童的体格发育现状及变化趋势,并提供0—7岁儿童的体格发育参考数据。方法采取随机整群抽样方法,调查北京、哈尔滨、西安、上海、南京、武汉、福州、广州、昆明九市及其郊区农村7岁以下儿童体格发育状况,包括体重、身高（长）、坐高（顶臀长）、头围、胸围5项指标;分男、女22个年龄组,各年龄组100—150人,共138775人。结果2005年九市儿童的体重、身高和坐高值与1995年相比有明显的增长,并且随年龄增长,增幅逐渐增大;头围、胸围也有不同程度增长。城区、郊区之间仍存在明显差别,但郊区儿童的身高增长速度快于城区,城市与郊区儿童的身高差别逐渐缩小。九市1975至2005年的4次调查数据比较显示：30年间我国儿童的体重、身高值呈现快速增长趋势,表现为第2个10年的增长速度快于第1个10年,第3个10年的增长速度又快于第2个10年。结论我国九市城区与郊区7岁以下儿童的体格发育生长水平及营养状况较10年前有明显改善,我国儿童体格生长发育仍处于长期趋势中的快速增长阶段。九市儿童的平均生长水平已达到2006年世界卫生组织颁布的儿童生长标准。     

乌鲁木齐市7岁以下维、汉族儿童体格发育调查

目的 调查乌鲁木齐市0～6岁维、汉族儿童生长发育现状,为提高儿童健康水平提供理论依据.方法 用整群随机抽样方法,调查乌鲁木齐市7区1县0～6岁维、汉族儿童体格发育状况,包括体重、身高、坐高、头围、胸围5项指标;用Z评分法评价0～6岁儿童体格发育状况.结果 0～6岁维、汉族儿童各项生长指标随年龄增长而增长,以小年龄组增长最快;同年龄的男童体重、身高均值大于女童;同年龄、同性别维、汉族儿童体重和身高之间差异无统计学意义,其余生长发育指标差别有统计学意义.乌鲁术齐市维、汉儿童体重、身高均值达到世界卫生组织颁布的标准.结论 乌鲁木齐市维、汉族儿童生长发育存在性别和民族差异,生长发育水平与2005年九市城区儿童体格发育相当,达到2006年世界卫生组织颁布的儿童生长标准.     

极低出生体重儿的婴幼儿时期生长发育情况调查

目的 了解低出生体重儿（ＶＬＢＷＩ）的婴幼儿时期生长发育情况。方法 对３０例存活的婴幼儿,于其出生后１２个月～４岁时随访,采有科教儿科研究所制定的０～４岁小儿精神发育检查表测发育值。结果 ＶＬＢＷＩ在婴幼儿时期约有３０％身高和体重生长落后,ＤＱ在中下及其以下水平占３７％,ＤＱ与出生体重及家庭环境有关。结论对ＶＬＢＷＩ婴幼儿３岁前加强早期教育和早期干预十分重要。     

不同出生体重儿0～6岁体格生长水平特点

为了解不同出生体重儿的生长发育规律，对巨大儿、早产低出生体重儿、足月小样儿和正常出生体重儿0～6岁的体格生长特点进行分析。结果显示：巨大儿在各年龄段的体重、身高和体块指数均为4组之最，其次为正常出生体重儿，低出生体重儿最小。体重增长速度在出生后头3个月以早产低出生体重儿最快，足月小样儿次之，巨大儿最慢；12个月以后，4组的体重增长速度接近相等。身高增长速度在生后头3个月以巨大儿最大；但3～12个月内，早产低出生体重儿生长最快。营养不良和矮身材发生率在低出生体重儿中最高，而肥胖发生率以巨大儿最高。提示应针对不同出生体重儿进行早期的生长监测和干预。     

青岛市0岁～14岁儿童生长发育指标的调查以及与现行评价标准的比较

为获得青岛市当前0岁－14岁儿童身高和体重的发育资料，包括年龄别身高，年龄别体重和身高别体重，并与目前所用标准比较，随机对8802名0岁－14岁健康儿童进行身高和体重测量，其中男4399岁，女4403名，各分为23个年龄组，获取各年龄组身高和体重的平均值及标准差，各身高段的体重平均值及标准差。用统计学方法与目前国内使用的全国9城市调查标准（1985年）及WHO推荐标准（1997年）进行比较。结果：取得了青岛市0岁－14岁男女童各年龄组的身高、体重正常平均值及标准差，各身高段的体重标准；大多数年龄组的身高与体重均值高于全国九城市调查标准及WHO推荐标准。提示青岛地区0岁－14岁儿童体格发育水平已达到或超过WHO标准，建议在评价儿童生长发育时应使用新的标准。     

金华市6～15岁儿童抽动障碍流行病学调查

目的了解金华市小学生及中学生抽动障碍流行特点、伴发的行为和情绪问题。方法对我市6所小学和6所中学的3152名6～15岁学龄儿童进行抽动障碍流行病学调查。结果共检出抽动障碍患者550例（17．45％），抽动障碍伴发不良行为和情绪问题。Tourette综合征抽动严重程度〉慢性运动或发声抽动障碍〉短暂性抽动障碍。结论6～15岁学龄儿童的抽动障碍患病率较高，部分可伴有行为和情绪问题。     

脐血IGF-1及IGFBP-3与胎儿生长发育的关系研究

目的探讨胰岛素样生长因子-1（IGF—1）及胰岛素样生长因子结合蛋白-2（IGFBP-3）与胎儿宫内生长发育的关系。方法将新生儿根据出生体重与胎龄的关系分为大于胎龄儿（IAG）、适于胎龄儿（AGA）、小于胎龄儿（SGA）三组,分别测定三组新生儿出生时身长、体重及胎盘重量,同时取脐血采用EUSA法测定IGF-1及IGFBP-3水平。结果①三组新生儿出生时身长、体重及胎盘重量3个指标比较差异均有统计学意义（P均〈0．05）。②脐血IGF-1及IGFBP-3水平在SGA、AGA、LGA三组间比较,LGA组〉AGA组〉SGA组,各组间比较差异均有统计学意义（P均〈0.05）。③胎儿发育的重要指标出生体重、身长及胎盘重量与IGF-1及IGFBP-3水平均呈正相关。结论IGF-1及IGFBP-3与胎儿生长发育密切相关,对胎儿的生长发育起重要的调节作用。     

不同剂量重组人生长激素治疗小于胎龄儿矮小症的疗效分析

目的 研究不同剂量重组人生长激素(rhGH)治疗小于胎龄儿(SGA)矮小症的效果和安全性。方法 收集SGA 矮小症患儿37 例,并根据使用剂量分为2 组:小剂量(每日0.1~0.15 IU/kg)rhGH 治疗组和大剂量rhGH 治疗组(每日0.16~0.2 IU/kg),比较两组患儿治疗后3、6、9、12 及24 个月时身高标准差的增长值(ΔHtSDS)、生长速率(HV)、血清胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)水平及空腹血糖等指标的变化。结果 大、小剂量rhGH 治疗后ΔHtSDS 及HV 均有提高,但大剂量组治疗后9、12 及24 个月时ΔHtSDS 及HV 均高于小剂量组(P<0.05)。大剂量和小剂量的rhGH 治疗均使血清IGF-1 和IGFBP-3 水平提高,且血清IGF-1 和IGFBP-3 水平与HtSDS 呈正相关。大小剂量组各有1 例患儿出现一过性空腹血糖轻微升高(均为6.1 mmol/L);两组甲状腺功能均无异常。结论 rhGH 治疗SGA 矮小症效果确切,不良反应少,其中大剂量较小剂量治疗更具优势。     

Normal visual evoked potentials in preschool children born small for gestational age

Aim: Previous studies have shown visual evoked potential (VEP) abnormalities in infants and animals born small for gestational age (SGA) compared with controls. The current exploratory study aims to investigate whether VEP abnormalities persist in older ages. Methods: Pattern VEP latencies were obtained in 21 children (11 girls, 10 boys), born SGA and moderately preterm, at an average age of 5 years and 8 months. Fifty‐one children (24 girls, 27 boys, mean age of 5 years and 7 months), also born moderately preterm but with normal height and weight at birth, served as controls Results: Visual evoked potential results showed no significant differences in latency between children born SGA and controls born appropriate for gestational age (AGA) for either binocular stimulation, right eye or left eye stimulation. Conclusions: Our findings do not indicate any differences in VEP latency at preschool age for children born SGA compared with children born AGA. The results may support previous studies, suggesting that children born SGA show accelerated neurophysiologic maturation during their first year of life and that previously delayed VEP latencies after catch‐up stay unchanged compared with controls.     

Serum copper in newborns and their mothers

Serum copper levels in the cord blood of 100 newborns and the respective maternal serum copper at the time of delivery was estimated by atomic absorption spectrophotometer. The cases were classified into term AGA, term SGA, term LGA, preterm AGA and preterm SGA. The mean maternal serum copper level 152.42 ± 2.06 μg/Jdl) was significantly higher than the mean cord serum copper level (39.84 ±1.19 μg/dl). There was positive correlation between the maternal serum copper level and cord serum copper level. The mean serum copper level of term neonates was (44.42 ± 1.26 μgJdl) significantly higher (p < 0.001) than that of preterm neonates (30.30 ± 1.14 μg/dl). There was a positive correlation between cord serum cooper level and gestational age. The mean cord serum copper levels of term AGA, term SGA, preterm AGA and preterm SGA neonates was 45.42 ± 1.44 μg/dl, 39.22 ± 2.45 μg/dl, 31.00 ± 2.11 udJdl and 29.47 ± 2.08 μg/dl respectively. There was no statistically significant difference in the mean serum copper level, of AGA and SGA group of both term and preterm noenates. The difference amongst mean maternal serum copper level of various neonatal groups was not significant.     

Growth curves and their associated weight and height factors in children from birth to 4 years old in West Azerbaijan Province,northwest Iran

Background

Growth trajectory standards are important components that need to be monitored for suitable child growth. This study examined longitudinal data to identify the factors affecting growth trajectory standards of height and weight for infants.

Craniofacial and acral growth responses in growth hormone-deficient children treated with growth hormone

OBJECTIVES: To investigate the effects of growth hormone (GH) therapy on craniofacial growth and body proportions in growth hormone deficient children. STUDY DESIGN: By using a cross-sectional study design, we investigated GH effects on craniofacial growth with photographic facial morphometrics, head circumference, and hand and foot size in 52 children with GH deficiency (GHD) treated with GH (0.27 mg/kg/wk) for 0.19 to 15.5 years, compared with untreated children with GHD and normal first-degree relatives. To detect disproportion and to correct for stature, age and height age (HA) SD scores were analyzed. RESULTS: Untreated subjects with GHD had retarded facial height and width (P values=.001) compared with normal controls; small head circumference for age and HA (P=.001); small hands for age (P<.001) that were large for HA (P=.003); and small feet for age (P<.001) that were normal for HA. When compared with normal controls, GH-treated subjects had proportional facial heights but narrower facial widths. Head circumference, however, increased disproportionately to height (P=.001), becoming large for stature, and increasing with duration of therapy and cumulative GH dose (P<.001). Hands and feet grew proportionately to height. CONCLUSION: Growth hormone treatment with conventional doses partially corrects craniofacial deficits and does not adversely affect hand and foot growth but appears to result in excessive head circumference growth.     

Placental IGF-I, IGFBP-1, zinc, and iron, and maternal and infant anthropometry at birth

Aim: To correlate placental protein levels of insulin‐like growth factor (IGF)‐I and insulin‐like growth factor binding protein (IGFBP)‐1, with previously determined levels of IGF‐I and IGF‐II mRNA expression, and the micronutrients zinc and iron, and maternal and newborn anthropometry. Methods: Placental samples were collected from rural field sites in Pakistan. Samples were divided into small and large for gestational age groups (SGA and LGA, respectively). IGFBP‐1 levels were assessed using Western immunoblotting. IGF‐I protein levels were assessed using ELISA techniques. IGF mRNA expression, zinc, and iron, were quantified as previously described and were used for comparative purposes only. Results: Thirty‐three subjects were included (SGA, n = 12; LGA n = 21). Higher levels of IGFBP‐1 were seen in the SGA group (p < 0.01). IGFBP‐1 correlated positively with maternal and infant triceps skin‐fold thickness in the LGA and SGA groups, respectively (p < 0.05). Significantly lower IGF‐I protein levels were seen in the SGA group. IGF‐I levels correlated significantly with maternal and newborn anthropometry. IGFBP‐1 correlated significantly with IGF‐II mRNA expression (p < 0.05). Conclusion: Placental protein levels of IGF‐I and IGFBP‐1 appear to be associated with maternal anthropometry. Maternal anthropometry may thus influence IGFBP‐1 and IGF‐I levels and may possibly be used for screening of pregnancies, with the potential for timely identification of these high‐risk pregnancies.     

Optimal birth weight percentile cut‐offs in defining small‐ or large‐for‐gestational‐age

Aims: It remains questionable what birth weight for gestational age percentile cut‐offs should be used in defining clinically important poor or excessive foetal growth. We aimed to evaluate the optimal birth weight percentile cut‐offs for defining small‐ or large‐for‐gestational‐age (SGA or LGA). Methods: In a birth cohort‐based analysis of 17 979 120 non‐malformation singleton live births, U.S. 1995–2001, we assessed the optimal birth weight percentile cut‐offs for defining SGA and LGA. The 25th–75th percentile group served as the reference. Primary outcomes are the risk ratios (RR) of neonatal death and low 5‐min Apgar score (<4) comparing SGA or LGA versus the reference group. More than 2‐fold risk elevations were considered clinically significant. Results: The 15th birth weight cut‐off already identified SGA infants at more than 2‐fold risk of neonatal death at pre‐term, term or post‐term, except for extremely pre‐term births <28 weeks (continuous risk reductions over increasing birth weight percentiles). LGA was associated with a reduced risk of low 5‐min Apgar score at pre‐term, but an elevated risk at term and post‐term. The 97th cut‐off identified LGA infants at 2‐fold risk of low 5‐min Apgar at term. Conclusion: The commonly used 10th and 90th birth weight percentile cut‐offs for defining SGA and LGA respectively seem largely arbitrary. The 15th and 97th percentiles may be the optimal cut‐offs to define SGA and LGA respectively.