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Assessment of Child Anthropometry in a Large Epidemiologic Study
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创建和评估新的增长图表,从世卫组织逐步过渡到疾病预防控制中心的价值
Carrie Daymont1,2, Wenke Hwang2, Ian M Paul1,2
1Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania.
Pediatrics
|August 17, 2025
概括
新的增长图表在世界卫生组织 (WHO) 和疾病控制和预防中心 (CDC) 标准之间顺利过渡,减少对儿童缓慢增加体重的过度识别. 这种方法可以提高使用真实数据的增长评估准确性.
科学领域:
- 儿科生长评估 儿科生长评估
- 公共卫生监督是对公共卫生的监督.
- 生物统计学 生物统计学
背景情况:
- 疾病控制和预防中心 (CDC) 建议在2岁时从世界卫生组织 (WHO) 增长标准突然切换到CDC 2000增长参考标准.
- 这种过渡可能会导致儿童生长z分数的显著,临床误导性变化,即使生长模式稳定.
- 准确的增长评估对于早期识别发展问题至关重要.
研究的目的:
- 开发和评估新的增长图表,在世卫组织和疾病预防控制中心的增长参考数据之间提供逐步过渡.
- 评估这些新图表对增长评估的影响,特别是身体质量指数 (BMI),体重和长度/身高z分数.
- 使用标准图表与逐渐过渡图表来比较显著的z分数变化的流行率.
主要方法:
- 开发了新的身体质量指数 (BMI),体重和长度/身高相对于年龄的图表,使用代方法进行逐步过渡.
- 进行了一项回顾性队列研究,使用CDC推的与逐步过渡图表比较1.5至2年的平均z分数变化.
- 分析了在两种图表类型中经历大z分数变化 (下降>1或上升<-1) 的儿童比例.
主要成果:
- 在2岁至5岁之间应用了加权平均过渡值.
- 疾病预防控制中心推的图表显示,7429名儿童的BMI-for-age z得分 (BMIz) 和体重-for-age z得分 (WTz) (分别为-0.59和-0.35) 的平均值显著下降.
- 渐进过渡图表将这些下降降至最低 (BMIz -0.09,WTz -0.01),并减少了z分数显著下降的儿童比例 (CDC:BMIz 28.3%,WTz 6.0%;渐进:BMIz 11.6%,WTz 0.85%).
结论:
- 创建了增长图表,以促进世卫组织和疾病预防控制中心标准之间的顺利过渡.
- 这些渐进的过渡图表显示了减少缓慢增加体重的过度识别的潜力.
- 开发的图表可能为儿科生长监测的临床实践和研究提供更好的实用性.
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