INTERGROWTH-21stとWHOの子供の成長基準を用いた新生児と子供の成長分類への影響
Linda Vesel1, Sara Strout2, Simon Parker2
1Ariadne Labs, Harvard T.H. Chan School of Public Health/Brigham and Women's Hospital, Boston, Massachusetts, USA.
BJOG : an international journal of obstetrics and gynaecology
|February 18, 2026
まとめ
INTERGROWTH-21st (IG-21st) 規格は,WHOの子供の成長基準 (WHO GS) と比較して,早産児の成長評価をより正確に提供しています. IG-21stの基準を使用すると,分類とモニタリングが改善され,特に最初の1年で改善されます.
科学分野:
- 小児科は小児科です.
- ネオナトロジーの新生児科
- 成長モニタリング
背景:
- 正確な成長評価は,乳児の期待されるパターンからの偏差を特定するために不可欠です.
- 既存の成長基準は,多様な乳児集団,特に早産の乳児を十分に反映していない可能性があります.
- WHOの子供の成長基準 (WHO GS) とINTERGROWTH-21st基準 (IG-21st) は広く使用されていますが,異なる分類が得られます.
研究 の 目的:
- 幼児の成長軌道の分類と解釈を,WHOのGSとIG-21stの基準を用いて比較する.
- 低出生体重の乳児の成長異常を特定する上で,異なる成長基準の影響を評価する.
主な方法:
- マラウイとタンザニアの608人の中程度の低出生体重の乳児を対象とした観察コホート研究の二次データ分析.
- 出生時にZスコア (体重対年齢,長さ対年齢,頭部周長対年齢) を計算し,WHOのGSおよびIG-21st標準の両方を使用して24ヶ月まで縦に計算します.
- 妊娠年齢サブグループ内の平均成長パターンからの偏差を評価するための条件付き成長モデルの構築.
主要な成果:
- 出生時に,IG-21st 新生児サイズ標準 (NBS) のzスコアはWHOのGSよりも高く,特に低妊娠年齢サブグループでは高かった.
- IG-21st Preterm Postnatal Standards (PPS) を用いて,WHOのGSと比較して,Zスコアが-2以下と分類された早産児の割合が著しく低い (例えば,体重:6.1%対95.6%).
- 標準的なz-スコア間の差異は,出生から6ヶ月までの早産児で最大で,6〜12ヶ月で減少し,受胎児では最小の差異が観察されました.
結論:
- WHOのGSだけでは,特に出生時および幼児期に,早産および満期の乳児の成長状態を誤って分類することがあります.
- IG-21stの規格は,より適切なGA特有の分類を提供し,予想される成長パターンとよりよく整合し,正確なモニタリングをサポートします.
- 推奨事項には,出生時にIG-21st NBS,月経後27~64週間のIG-21st PPS,その後WHO GSの使用が含まれています.
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