使用INTERGROWTH-21st和世卫组织儿童成长标准对新生儿和儿童成长分类的影响
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
概括
与世卫组织儿童生长标准 (WHO GS) 相比,INTERGROWTH-21st (IG-21st) 标准为早产婴儿提供了更准确的生长评估. 使用IG-21标准可以改善分类和监测,特别是在生命的第一年.
科学领域:
- 儿科 儿科 儿科
- 新生儿科学 新生儿科学
- 增长监测 增长监测 增长监测
背景情况:
- 准确的生长评估对于识别婴儿与预期模式的偏差至关重要.
- 现有的生长标准可能无法充分代表各种婴儿群体,特别是早产婴儿.
- 世卫组织儿童成长标准 (WHO GS) 和INTERGROWTH-21st标准 (IG-21st) 被广泛使用,但可能产生不同的分类.
研究的目的:
- 使用世卫组织GS和IG-21标准对婴儿生长轨迹的分类和解释进行比较.
- 评估不同生长标准对识别低出生体重婴儿生长异常的影响.
主要方法:
- 一项观察性队列研究的二次数据分析,该研究涉及马拉维和坦桑尼亚的608名中度低出生体重的婴儿.
- 计算Z-分数 (体重-年龄,长度-年龄,头周长-年龄) 在出生时和纵向直到24个月使用WHOGS和IG-21标准.
- 构建条件增长模型,以评估妊娠年龄子组内的平均增长模式的偏差.
主要成果:
- 在出生时,IG-21st新生儿尺寸标准 (NBS) 的z分数高于世卫组织GS,特别是在较低的妊娠年龄小组中.
- 在使用IG-21st早产产后标准 (PPS) 与WHOGS相比,分类Z分数低于-2的早产婴儿的比例明显较低 (例如,体重:6.1%与95.6%相比).
- 标准z-score之间的差异在出生至6个月的早产婴儿中最大,减少6-12个月,在预产婴儿中观察到的差异很小.
结论:
- 仅仅世卫组织的GS可能会错误地分类早产和满期婴儿的生长状况,特别是在出生和婴儿时期.
- 第21届IG标准提供了更合适的GA特定分类,更好地与预期的增长模式保持一致,并支持准确的监测.
- 建议包括在出生时使用IG-21st NBS,从27周到64周的月经后使用IG-21st PPS,以及此后使用WHO GS.
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