宁夏吴忠市7岁以下儿童生长状况及影响因素分析

目的：了解宁夏吴忠市7岁以下儿童生长状况及影响因素,为制定相关干预措施提供参考依据。方法：采用分层整群的抽样方法,对宁夏吴忠市两县区7岁以下儿童进行了调查,生长状况采用Z评分法评价。结果：7岁以下儿童生长迟缓、低体重、消瘦的发生率分别为12.58%、5.71%、5.55%。儿童年龄的身高Z评分(HAZ)、年龄的体重Z评分(WAZ)以及身高的体重Z评分(WHZ)均值分别为-0.26±2.50、0.29±4.54和0.65±3.02。不同民族儿童消瘦发生率差异有统计学意义（P＜0.05）,不同地区和不同年龄段儿童生长迟缓发生率、低体重的发生率差异有统计学意义（P＜0.05）。儿童生长迟缓的主要影响因素为地区（OR=0.369,P＜0.001）、民族（OR=1.694,P=0.027）、儿童年龄（OR=1.143,P=0.002）。低体重的主要影响因素为地区（OR=0.453,P=0.001）、儿童年龄（OR=1.204,P=0.002）。消瘦的主要影响因素为民族（OR=1.735,P=0.024）。结论：吴忠市7岁儿童生长水平欠佳,其生长水平与民族、地区、年龄等因素有关。     

北京城区5~14岁儿童最大呼气峰流速值测定研究

目的确定北京城区5~14岁儿童用峰流速仪测定的最大呼气峰流速(PEFR)的正常值范围,建立本地正常预计值方程、并与肺量仪测定的呼气峰流速值进行比较。方法选择幼儿园和中小学5~14岁正常儿童425名,男213名,女212名。采用德国百瑞峰流速仪测定呼气峰流速值,记录性别、年龄、身高、体重等生理参数。同时用德国Jaeger肺量仪测定流量-容积曲线,获得最大呼气峰流速(PEF)值。采用SPSS13.0统计软件比较分析峰流速仪与肺量仪测定所获峰流速值的差异。经线性回归获得PEFR回归方程式。结果随着儿童年龄的增加,其PEFR逐渐增加,不同年龄组间差异存在统计学意义(P0.05)。同一年龄组男性儿童PEFR高于女性儿童,并在11、13、14岁组存在统计学意义(P0.05);无论男女,PEFR均与年龄、身高、体重呈显著正相关,其中与身高相关性最高,年龄、体重次之;建立了5~14岁不同性别儿童PFER值的多元回归方程,分别为PEFR(L/min)=5.29×H-427.1(男性儿童)和PEFR(L/min)=4.94×H-399.8(女性儿童)。总体上,峰流速仪测得的PEFR值(309.1±74.1 L/min)略高于肺量仪测得的PEF值(298.9±91.3 L/min),其差异存在统计学意义(P0.001)。结论建立了新形势下北京地区5~14岁儿童PEFR的正常值及回归方程,为儿童呼吸道疾病的临床诊治提供参考。     

少年儿童肺通气功能正常值与预计方程式

目的　建立儿童常规用力肺功能的正常参考值 ,并探讨儿童用力肺功能的特点。方法对广州地区 6～ 14岁正常儿童 385名 (男 2 0 0名 ,女 185名 ) ,采用美国Gould公司生产的 2 80 0型肺量计 ,参考美国胸科协会标准测定用力肺活量 (FVC)、1s用力呼气容积 (FEV1)、1s用力呼气容积占用力肺活量比值 (FEV1/FVC)等 13个指标 ,并对各实测指标作多元逐步线性回归及曲线回归 ,得出预计方程式。比较本方程与国内外常用预计值对指定身高、体重、年龄的儿童的差异。结果　FVC在各年龄组间差异有显著意义 (F(男 ) =4.5 6 2 ,F(女 ) =5 .137,P均 <0 .0 1) ;肺功能指标与身高、体重和年龄均呈密切正相关 ,但大多数肺功能指标与身高的关系最为密切 (如FEV1,男 =0 14145 3×身高0 0 193 8,r =0 93178,女 =0 12 70 97×身高0 0 19676,r=0 90 382 ,P均 <0 0 0 1)。儿童平均呼气时间 3.11s。建立了各肺功能指标的多元回归方程。结论　肺功能指标受身高变化影响大于体重和年龄变化 ;建立并推荐华南地区使用本儿童肺功能正常预计值。     

儿童血浆同型半胱氨酸水平与原发性高血压相关性研究

目的 了解儿童血浆同型半胱氨酸水平,分析其与儿童原发性高血压的相关性.方法 2004--2006年对北京3～18岁儿童和青少年2万余人进行了血压、血糖、血脂及肥胖的流行病学抽样调查.本研究随机抽取其中6～10岁原发性高血压儿童,男女各20例,另选学校体检血压正常的相应年龄段的男女儿童各20例作为对照组.两组儿童均经临床病史、体检、实验室检查除外其它心肺、泌尿、内分泌等疾病.采用高效液相色谱电化学内标法进行了血浆同型半胱氨酸水平测定.结果结果:男童高血压组与血压正常组收缩压分别为(119±9)mmHg、(102±5)mmHg(P<0.001),舒张压分别为(76±6)mmHg、(66±6)mmHg(P<0.001);女童高血压组与血压正常组收缩压分别为(118±7)mmHg、(101±7)mmHg(P<0.001),舒张压分别为(76±10)mmHg、(63±9)mmHg(P<0.001);本研究6～10岁血压正常儿童血浆同型半胱氨酸几何均值为(8.5±1.3)μmol/L,其中男童为(8.0±1.3)μmol/L,女童为(9.1±1.3)μmol/L,二者差异无统计学意义(P=0.126).男女高血压组血浆同型半胱氨酸水平高于血压正常组,男童分别为(10.2±1.5)μmol/L、(8.0±1.3)μmol/L,P=0.024;女童分别为(12.2±1.5)μmol/L、(9.1±1.3)μmol/L,P=0.008.控制性别,血浆同型半胱氨酸水平与年龄呈正相关(r=0.31.P=0.006),控制年龄、性别,血浆同型半胱氨酸水平与收缩压和舒张压均呈正相关,与BMI、血糖,甘油三酯及总胆固醇无明显相关性.进一步控制BMI、血糖、甘油三酯及总胆固醇,同型半胱氨酸与收缩压和舒张压的正相关关系依然存在,偏相关系数分别为(r=0.265,P=0.024)和(r=0.347,P=0.003).结论 儿童血浆同型半胱氨酸水平与血压正相关,高血压儿童血浆同型半胱氨酸水平高于血压正常的同龄儿童.     

广州地区382名健康学龄儿童脉冲振荡肺功能的测定

目的　探讨儿童脉冲振荡肺功能技术 (IOS)的特点 ,建立国内儿童的正常参考值。方法对 382例 6～ 14岁正常儿童 (男性 196例 ,女性 186例 ) ,采用德国Jaeger公司生产的MasterscreenIOS肺功能仪 ,参考欧洲呼吸学会标准测定呼吸总阻抗 (Zrs)、不同振荡频率 (5Hz～ 35Hz)的粘性阻抗 (Rrs)及电抗 (Xrs)、响应频率 (Fres)等 2 0个指标 ,并对各实测指标作多元逐步线性回归及曲线回归 ,得出预计方程式。以实测数据与试验所得方程的预计值及Lechtenboerger方程式预计值进行相关系数的配对比较。结果　Zrs、Rrs与儿童生长 (身高及年龄 )呈负相关 [Zrs(男 ) =- 1 0 4 8+2 34 398/身高 ,r =-0 839,P <0 0 0 1;Zrs(女 ) =- 1 14 8+2 4 4 36 6 /身高 ,r=- 0 812 ,P <0 0 0 1];而Xrs则与儿童生长呈正相关 ,且变异减少。振荡频率 5Hz与 2 0Hz下的气道阻力之差 (R5-R2 0 )与儿童身高呈负相关 ,R5-R2 0 (男 ) =0 74 9- 0 0 0 4 3×身高 ,r=- 0 6 86 ,P <0 0 0 1;R5-R2 0 (女 ) =0 85 1- 0 0 0 5 1×身高 ,r=-0 6 2 7,P <0 0 0 1。多数IOS参数与身高的关系最为密切 ,年龄次之 ,体重的影响相对较少 ;建立了各IOS呼吸阻抗主要指标的多元回归方程式。IOS各实测值与所得方程预计值的相关系数均大     

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目的初步分析3～6岁学龄前儿童血清视黄醇结合蛋白4(RBP4)与儿童身高(HT)、体重(WT)、年龄的身高的Z评分(HAZ)、年龄的体重的Z评分(WAZ)、身高的体重的Z评分(WHZ)、体重指数(BMI)及体重指数Z评分(BMIZ)的关系。方法 2010年10至12月采用整群抽样和分层抽样相结合的方法分别抽取成都市郫县花园镇8所幼儿园481名3～6岁学龄前儿童,测定WT、HT及血清RBP4水平。结果共370名完成检测,其中男188名,女182名;平均年龄(47.1±14.4)个月。偏相关分析显示,血清RBP4分别与WHZ、BMI和BMIZ存在明显正相关,偏相关系数r分别为0.18、0.21和0.20(P均<0.05);而与WT、HT、HAZ和WAZ则无明显相关性(P>0.05)。以各体格指标中位数为界,WHZ、BMI和BMIZ高组血清RBP4显著高于低组(P<0.05),而WT、HT、HAZ和WAZ高组与低组间RBP4差异无统计学意义(P>0.05)。以RBP4浓度的P25、P50及P75为界,仅BMIZ差异有统计学意义(P<0.05)。结论机体体脂成分影响学龄前儿童血清RBP4,而血清RBP4对体脂成分影响较小。     

矮小症儿童健康相关生活质量分析

目的比较分析矮小症与正常身高儿童健康相关生活质量的差异。方法选取2015年10月至2016年4月就诊于济宁医学院附属医院生长发育门诊且符合入选标准的494例5~18岁儿童及其主要监护人为研究对象。将494例分为矮小症组、身高偏矮组、正常身高组,采用Peds QL4.0核心通用量表进行横断面研究。结果 (1)Peds QL4.0核心通用家长代评量表中,矮小症组、身高偏矮组、正常身高组总分分别为77.69±12.46,82.63±12.20,89.01±10.24(P0.001);儿童自评量表中,总分分别为74.20±11.94,80.43±11.38,88.21±8.45(P0.001)。(2)校正混杂因素后,矮小症组在Peds QL4.0核心通用自评与代评量表总分及各维度的评分仍最低,身高偏矮组次之,正常身高组最高(P0.05)。(3)40例GHD患儿与21例ISS患儿相比,自评与代评量表在总分及各维度的评分差异无统计学意义(P0.05)。结论身材矮小对儿童健康相关生活质量有负面影响。     

南京市3～6岁健康儿童超声跟骨骨密度测定

目的 检测南京地区3～6岁健康儿童跟骨骨密度(BMD)水平,建立本地区学龄前期儿童超声BMD正常参考值.方法　选择2008年4月-2009年6月在南京医科大学附属妇幼保健院体检的579例3～6岁健康儿童,以每0.5岁分组将579例儿童分为≥3.0～3.5岁、≥3.5～4.0岁、≥4.0～4.5岁、≥4.5～5.0岁、≥5.0～5.5岁及≥5.5～6.0岁共6组.采用定量超声仪测定各年龄组儿童足跟部BMD值,同时测量受检者身高、体质量,并计算其体质量指数,应用SPSS 10.0软件进行统计学分析.结果 各年龄组男童女童之间BMD值比较差异无统计学意义(Pa＞0.05),随着年龄增长,BMD在总体上呈增加趋势.3～6岁儿童BMD值与身高呈正相关(r=0.123,P=0.010),与体质量及BMI无相关性(r=0.069、-0.026,P=0.151、0.589).结论　学龄前期儿童BMD无性别差异,BMD与年龄、身高相关,应根据不同年龄组建立儿童BMD参考值.     

学龄早期注意缺陷多动障碍儿童事件相关电位和行为问题的相关性

目的采用事件相关电位(ERP)技术和Achenbach儿童行为量表(CBCL)研究学龄早期注意缺陷多动障碍(ADHD)儿童的认知特征,探讨ERP与儿童行为问题的相关性。方法 22例6~7岁ADHD患儿和年龄匹配的19例正常儿童纳入研究。ERP试验采用持续性操作测试(CPT-AX)任务,对Go和Nogo的N2、P3成分进行波幅和潜伏期的比较分析。CBCL量表由患儿家长填写,分析行为因子与ERP成分的相关性。结果 ADHD组ERP遗漏数明显高于正常对照组(10±8 vs 5±4,P0.05),而两组反应时间和虚报数比较差异无统计学意义(P0.05)。ADHD组ERP的Go-N2波幅明显低于正常对照组(-8±5μV vs-10±4μV,P0.05)。ADHD组多动、攻击问题检出率均为27%,违纪问题检出率为9%。攻击及违纪因子得分与ERP的Go-N2波幅呈负相关(分别r=-0.43、r=-0.48,均P0.05),多动因子得分与Go-P3潜伏期呈正相关(r=0.50,P0.05)。结论学龄早期ADHD儿童已出现注意执行功能受损趋势,但抑制功能缺陷尚不明显。学龄早期ADHD儿童多动、攻击及违纪问题与ERP相关。     

儿童阻塞性睡眠呼吸暂停低通气综合征多系统影响的研究

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopneasyndrome,OSAHS)对儿童多器官系统的影响.方法 选择2009年3月至2010年12月在温州医学院附属第二医院、育英儿童医院睡眠障碍诊疗中心,经多导睡眠监测仪( polysomnography,PSG)监测确诊为OSAHS的儿童89例,根据病情轻重分为轻度组59例、中重度组30例,选取同期来本院体检的健康儿童100例为正常对照组.测量身高、体重、体重指数、血压,记录腺样体面容、牙咬合情况,测定血常规、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血糖和胰岛素水平,检查心电图和心脏B超,比较各组结果.结果 OSAHS轻度组、中重度组体重(kg)分别为23.3 ±10.1、21.9±8.4,身高(cm) 114.9±16.2、110.8±13.3,均低于正常组(31.8±10.1、136.1±15.1)(P ＜0.05),腺样体面容发生率23.7％、26.7％,牙咬合异常率74.6％、60.0％,明显高于正常组(0,4％)(P＜0.05);OSAHS中重度组高密度脂蛋白胆固醇[(1.20±0.30) mmol/L]、胰岛素[2.79 (0.84～16.16) mU/L]低于正常组[(1.40±0.27) mmol/L、4.92(0.76～16.80) mU/L],低密度脂蛋白胆固醇[ (2.61 ±0.75) mmol/L]高于正常组[(2.32 ±0.62) mmol/L] (P ＜0.05);OSAHS轻度组、中重度组红细胞计数(×1012/L)分别为4.93 ±0.37、5.23 ±0.22,血小板计数(×109/L) 292.92±75.64、292.50±63.05,明显高于正常组(4.70 ±0.31,255.60±69.12) (P＜ 0.05),收缩压(mm Hg,1 mm Hg =0.133 kPa)分别为98.54±10.44、99.13±19.13,高于正常组(87.88±11.37) (P ＜0.05),右室内径(mm) (14.24±1.64、13.17±2.07)小于正常组(16.10±2.96),主肺动脉内径(mm)(17.05±3.33、16.33±3.14)大于正常组(14.11 ±2.52),右室壁厚(mm) (3.43±0.26、3.57 ±0.20)大于正常组(3.32 ±0.25) (P ＜0.05),OSAHS中重度组心率[(94.43 ±10.64)次/min]比正常组[ (87.12±16.20)次/min]增快(P＜0.05);OSAHS中重度组与轻度组比较差异无统计学意义(P＞0.05).结论 儿童OSAHS颌面发育畸形明显,可以影响其他系统的功能,有生长发育减缓、代谢紊乱、血液黏度增加、血压升高、心脏结构改变的倾向.     

Haemoglobin and ferritin concentrations in children aged 12 and 18 months. ALSPAC Children in Focus Study Team.

AIMS: To define the normal ranges and investigate associated factors for haemoglobin and ferritin in British children at 12 and 18 months of age, and to estimate correlations between both haemoglobin and ferritin concentrations at 8, 12, and 18 months of age. SUBJECTS AND METHODS: Subjects were part of the "children in focus" sample, randomly selected from the Avon longitudinal study of pregnancy and childhood. Capillary blood samples were taken from 940 children at 12 months and 827 children at 18 months of age. RESULTS: Haemoglobin was distributed normally and ferritin was distributed log normally at 12 and 18 months of age. Ninety five per cent reference ranges were established from empirical centiles of haemoglobin and ferritin. Haemoglobin concentrations at 18 months were associated with sex and maternal education. Concentrations of ferritin at 12 and 18 months of age were associated with birth weight and current weight. Girls at 12 months, but not at 18 months, had 8% higher ferritin concentrations than boys. Haemoglobin and ferritin concentrations were significantly correlated over time (8-12 months: rHb = 0.26, rFer = 0.46; 12-18 months: rHb = 0.37, rFer = 0.34; 8-18 months: rHb = 0.22, rFer = 0.24). CONCLUSION: Iron stores are depleted by rapid growth in infancy. A definition of anaemia based on the fifth centile gives cut off points at 12 and 18 months of age of haemoglobin < 100 g/l, and for iron deficiency of ferritin < 16 micrograms/l and < 12 micrograms/l, respectively. Because children below the fifth centile at one time point differ from those six months later, it is unclear whether screening would be effective.     

上海地区足月新生儿肛门生殖器距离的正常范围测定和影响因素分析

目的:建立足月新生儿肛门生殖器距离(AGD)的正常参考值,并探讨可能影响新生儿AGD的相关因素。方法:选取2017年11月至2019年3月在上海交通大学医学院附属瑞金医院分娩的胎龄≥37周的新生儿,收集母亲和新生儿的一般资料信息,测量新生儿AGD数据。认定男性肛门中心至阴囊基底部的距离即为男性AGD,女性肛门中心至阴唇...     

The Urinary C-Peptide Excretion in Normal Healthy Children

ABSTRACT. The 24 h urinary C-peptide excretion was determined in 137 normal healthy children, 52 girls and 85 boys, 3–15 years of age. No significant difference was found between boys and girls. Median value of urinary C-peptide for boys and girls was 0.24 nmol/kg/24 h with a range of 0.07-0.61 nmol/kg/24 h. Urinary C-peptide correlated positively and significantly with age, weight, height, body surface area and the 24 h urinary creatinine excretion. Since the values of C-peptide excretion were not normally distributed they were log transformed and plotted against body weight. The linear regression and the 95% confidence limits were then calculated. Girls at puberty, 11–15 years of age, had significantly higher C-peptide excretion per kg body weight and per body surface area than younger girls, 3–10 years of age. Boys 13–15 years of age had significantly higher C-peptide excretion per body surface area than younger boys, 5–12 years of age. This indicates that children during the maximal growth spurt have an increased insulin secretion as measured by urinary C-peptide per body surface area.     

Head circumference, height, bone age and weight in 103 children with congenital hypothyroidism before and during thyroid hormone replacement

Head circumference, height, bone age and weight were studied in 103 children with congenital hypothyroidism before and up to 8 years of thyroid replacement therapy. The patients were divided into 4 groups according to the age at start of treatment: group I (diagnosed by neonatal screening): less than 2 weeks (n = 55); group II: 1-3 months (n = 7); group III: 4-12 months (n = 15); group IV: greater than 1 year of age (n = 26). Before treatment, group I showed a head circumference significantly larger than normal and a delay in bone maturation in the presence of normal length and weight. In the other groups length as well as bone age were significantly lower than normal, head circumference, in contrast, was normal (groups II and III) or even increased (group IV). During therapy, head circumference and bone age of group I became normal as were length and weight from the beginning. In the other groups, therapy led to a further increase of head size resulting in a mean head circumference significantly larger than normal during 8 years of observation in group IV. There was a catch-up of height, bone age and weight in groups II, III and IV; mean height of late treated children (group IV), however, remained significantly lower than normal even after 8 years of therapy. - Our study shows that congenital hypothyroidism is associated with increased head circumference, either absolutely or in relation to stature. Thyroid hormone therapy resulted in a normalization of head growth when treatment was initiated early, and in a further increase when treatment was started late. There was a catch-up of height, bone age and weight; complete normalization, however, occurred only in those children treated before one year of age.     

Childhood and adolescent growth of patients with sickle cell disease in Aracaju, Sergipe, north-east Brazil

Sickle cell disease (SCD) is the most prevalent inherited monogenic pathology in South America. Although children with SCD have normal birthweight, weight deficit is often seen from early childhood. On the other hand, paradoxically, normal final height associated with delayed puberty has been reported from Brazil and Jamaica. This cross-sectional study describes the growth pattern by age and sex in 76 children and adolescents with SCD in Sergipe, north-east Brazil with a median age of 110 months. Median weights and heights for age were below the NCHS standards. The weight and height deficits were statistically significant for boys of all ages, except for 7-year-olds. Most girls have median weights and heights below the NCHS standards but this only becomes statistically significant at 15 years of age. Family channels were calculated from the parents' heights. The observed height was lower than the expected percentile value for the family in seven (41%) children, equal to expected family height in six (35%) and above expected family height in four (24%) of 17 teenagers. Our findings suggest that Brazilian children with SCD do not attain normal height and weight. It is therefore likely that, although maximum height and weight velocity occur significantly later than normal due to delayed puberty, the magnitude of this spurt is less than normal.     

Human adipose tissue in culture. VI. Effect of age on cell size and lipolysis.

Biopsies of subcutaneous adipose tissue were taken from children varying in age from a few hours to 15 years. In 63 children the cell diameter was determined. Weight in relation to height was normal. At an average the fat cell weight was 0.05 mug in the new-born, but adolescent values were reached within the first year of life. Biopsies from 23 children were incubated for one week in vitro. Cell size was not changed significantly during this period. Glycerol release was strongly correlated to cell size and the long-term effect of insulin on the lipolysis was found to be stimulating as previously shown for adults. At the same cell size basal lipolysis was higher in children below one year of age than later in life. It is concluded that the tissue culture method may be used for studies of adopose tissue from children. Furthermore, the data indicate that there is a difference in adipose tissue metabolism and cell size of children below one year as compared to older children and adults.     

The urinary C-peptide excretion in normal healthy children

The 24 h urinary C-peptide excretion was determined in 137 normal healthy children, 52 girls and 85 boys, 3-15 years of age. No significant difference was found between boys and girls. Median value of urinary C-peptide for boys and girls was 0.24 nmol/kg/24 h with a range of 0.07-0.61 nmol/kg/24 h. Urinary C-peptide correlated positively and significantly with age, weight, height, body surface area and the 24 h urinary creatinine excretion. Since the values of C-peptide excretion were not normally distributed they were log transformed and plotted against body weight. The linear regression and the 95% confidence limits were then calculated. Girls at puberty, 11-15 years of age, had significantly higher C-peptide excretion per kg body weight and per body surface area than younger girls, 3-10 years of age. Boys 13-15 years of age had significantly higher C-peptide excretion per body surface area than younger boys, 5-12 years of age. This indicates that children during the maximal growth spurt have an increased insulin secretion as measured by urinary C-peptide per body surface area.     

HUMAN ADIPOSE TISSUE IN CULTURE VI. Effect of Age on Cell Size and Lipolysis

Abstract. Biopsies of subcutaneous adipose tissue were taken from children varying in age from a few hours to 15 years. In 63 children the cell diameter was determined. Weight in relation to height was normal. At an average the fat cell weight was 0.05 μg in the new-born, but adolescent values were reached within the first year of life. Biopsies from 23 children were incubated for one week in vitro. Cell size was not changed significantly during this period. Glycerol release was strongly correlated to cell size and the long-term effect of insulin on the lipolysis was found to be stimulating as previously shown for adults. At the same cell size basal lipolysis was higher in children below one year of age than later in life. It is concluded that the tissue culture method may be used for studies of adipose tissue from children. Furthermore, the data indicate that there is a difference in adipose tissue metabolism and cell size of children below one year as compared to older children and adults.     

Metacarpal measurements in X-linked hypophosphataemic rickets

In 15 girls and 7 boys with hypophosphataemic vitamin D-resistant rickets, midshaft diameter, combined cortical thickness, cortical area and metacarpal length were determined in the second metacarpal on radiographs of the left hand. The values obtained were compared with age-matched and height-matched controls. In a longitudinal study the same bone measurements were taken in these 22 patients and in additional 3 boys. The metacarpal diameter in the patients was increased whereas the combined cortical thickness was decreased. The former feature appeared to have its onset in early childhood. Cortical area was normal for age and increased for height, which was taken to indicate a normal or increased bone mass in these children. Metacarpal length was normal for age and height in the boys and increased for height but still within the normal range in girls. This is in agreement with the normal arm-span that has been found in these children.     

Effects of prematurity and dysmaturity on growth at age 5 years

Forty-two term and 106 preterm appropriate for gestational age (AGA), and 43 term and 31 preterm small for gestational age (SGA) children were observed from birth to age 5 years. Parents' weight and height were also measured in 193 subjects including 97 couples. The percentage of short children was higher in SGA (17%) than in AGA (3.4%) children (P less than 0.01). This difference was significant in the preterm but not in the term children, suggesting that early failure of growth in utero can result in reduced growth in children. The findings were similar for weight and head circumference, but microcephaly was more frequent in term SGA (30%) than in preterm SGA (6.4%) children (P less than 0.05), suggesting that late impaired growth in utero can result in poor growth of the head. Height at the age of 5 years correlated with the parents' height only in AGA children, and with length at birth in SGA children. Weight of the 5-year-old children correlated with the mother's weight only in AGA children. Multivariate analysis in 66 couples and their children confirmed a greater tendency toward the influence of parental factors in AGA children and a more significant relationship with perinatal factors in SGA children.