英国等八个国家的研究人员通过横断面调查的方法,测量新生儿的体重、身长、头围等指标,目标是制定胎儿、新生儿以及早产儿出生后生长期的国际标准

—2014年9月6日《柳叶刀》


中文翻译


 

【题目】根据胎龄和性别,所得的新生儿体重、身长和头围的国际标准:INTERGROWTH-21st项目的新生儿横断面调查

【译文】

背景:2006年,WHO发布了5岁以下儿童的国际生长标准,现在已经被全世界接受。在INTERGROWTH-21st项目中,我们的目标是制定胎儿、新生儿以及早产儿出生后生长期的国际标准,以对之前的标准进一步进行补充。

方法:INTERGROWTH-21st是基于人群的项目,在八个地理学上定义的城市人口中评估胎儿生长和新生儿尺寸大小。入选母亲的绝大部分健康和营养需求都得以满足,并能获得充足的产前保健,以及在胎儿成长过程中没有受主要的环境上的约束。作为新生儿横断面调查研究(NCSS)的一部分,也是INTERGROWTH-21st项目的一个组成部分,我们测量全部新生儿的体重、身长、头围;还并前瞻性的收集了妊娠期和围产期的资料。为了建立新生儿的标准,我们选定的全部孕妇均满足(除了基本的人口特征)严格的个体合格标准,以确定该个体处于胎儿生长的低风险人群(标记为NCSS制定的亚群体)。妊娠14周以前,采用胎儿的头臀径;如果在怀孕14-24周或者更早开始产前保健,或者采用顶骨间双顶径,对妇女的胎龄进行可靠的超声评估。新生儿出生12小时内经统一培训的人体测量小组人员采用所有研究点均相同的仪器进行人体测量。采用分数多项式假定的偏态 分布来估计拟合的百分位数。

发现:在2009514日至201382日期间,我们从59 137名怀孕的妇女中确定了20 48635%)名符合标准的妇女。我们计算不同性别、新生儿的怀孕周数、体重、身长和头围的实测值和平滑百分位数。实测值和平滑百分位数几乎是相同的。根据孕周和性别,我们提出第310509097的百分数曲线。

说明:为了常规临床实践,我们已经制订了国际人体测量的标准来评估新生儿的大小,目标是对WHO儿童生长的标准进行补充,并允许不同民族的人群进行比较。

英文原稿


 

[Title] International standards for newborn weight, length, and head circumference by gestational age

and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project
[Authors] José Villar, Leila Cheikh Ismail, Cesar G Victora, Eric O Ohuma, Enrico Bertino, Doug G
Altman, Ann Lambert, Aris T Papageorghiou, Maria Carvalho, Yasmin A Jaffer, Michael G Gravett,
Manorama Purwar, Ihunnaya O Frederick, Alison J Noble, Ruyan Pang, Fernando C Barros, Cameron
Chumlea,Zulfiqar A Bhutta, Stephen H Kennedy
[Abstract]
Background: In 2006, WHO published international growth standards for children younger than 5 years,
which are now accepted worldwide. In the INTERGROWTH-21st Project, our aim was to complement
them by developing international standards for fetuses, newborn infants, and the postnatal growth period
of preterm infants.

Methods: INTERGROWTH-21st is a population-based project that assessed fetal growth and newborn
size in eight geographically defined urban populations. These groups were selected because most of the
health and nutrition needs of mothers were met, adequate antenatal care was provided, and there were
no major environmental constraints on growth. As part of the Newborn Cross-Sectional Study (NCSS),
a component of INTERGROWTH-21st Project, we measured weight, length, and head circumference
in all newborn infants, in addition to collecting data prospectively for pregnancy and the perinatal period.
To construct the newborn standards, we selected all pregnancies in women meeting (in addition to the
underlying population characteristics) strict individual eligibility criteria for a population at low risk of
impaired fetal growth (labelled the NCSS prescriptive subpopulation). Women had a reliable ultrasound
estimate of gestational age using crown—rump length before 14 weeks of gestation or biparietal
diameter if antenatal care started between 14 weeks and 24 weeks or less of gestation. Newborn
anthropometric measures were obtained within 12 h of birth by identically trained anthropometric teams
using the same equipment at all sites. Fractional polynomials assuming a skewed t distribution were used
to estimate the fitted centiles.
Findings: We identified 20 486 (35%) eligible women from the 59 137 pregnant women enrolled in NCSS
between May 14, 2009, and Aug 2, 2013. We calculated sex-specific observed and smoothed centiles for
weight, length, and head circumference for gestational age at birth. The observed and smoothed centiles
were almost identical. We present the 3rd, 10th, 50th, 90th, and 97th centile curves according to
gestational age and sex.

原文地址

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60932-6/abstract

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