Comparison of the World Health Organization (WHO) Child Growth Standards and the National Center for Health Statistics/WHO international growth reference: implications for child health programmes
Comparison of the World Health Organization (WHO) Child Growth Standards and the National Center for Health Statistics/WHO international growth reference: implications for child health programmes
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DOI：
10.1017/phn20062005
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发表时间：
2006-10-01
影响因子：
3.2
通讯作者：
Yang, Hong
中科院分区：
文献类型：
--
作者：
de Onis, Mercedes;Onyango, Adelheid W.;Yang, Hong
目的：比较根据世界卫生组织（世卫组织）儿童生长标准（“世卫组织标准”）和国家卫生统计中心(NCHS)/世卫组织国际生长参考（“NCHS参考”）的生长模式和营养不良估计，并讨论对儿童健康规划的影响。设计：对纵向数据进行二次分析，比较生长模式（出生至12个月）和两次横断面调查的数据，比较五岁以下儿童营养不良的估计情况。环境：孟加拉国、多米尼加共和国以及来自北美和北欧的婴儿集合样本。研究对象：婴儿和儿童分别为4787、10381和226名。结果：健康的母乳喂养婴儿遵循世界卫生组织标准的年龄体重平均z分数，而从2个月开始，在国家卫生统计中心的参考资料中出现了动摇。体重不足率在头6个月上升，此后根据世卫组织标准下降。按照世界卫生组织的标准，所有年龄组的发育迟缓率都较高。在婴儿期的前半段，消瘦和严重消瘦的比例要高得多。此后，严重消瘦的流行率继续是国家人口统计中心参考值的1.5至2.5倍。根据世卫组织标准，超重率的增幅因年龄组而异，总体相对增幅为34%。结论：世卫组织标准为监测婴儿早期快速变化的生长速度提供了更好的工具。它们的采用将在评估哺乳表现和婴儿喂养是否适当方面对儿童健康产生重要影响。营养不良人口估计数因年龄、生长指标和指数人口的营养状况而异。
Objectives: To compare growth patterns and estimates of malnutrition based on the World Health Organization (WHO) Child Growth Standards ('the WHO standards') and the National Center for Health Statistics (NCHS)/WHO international growth reference ('the NCHS reference'), and discuss implications for child health programmes.Design: Secondary analysis of longitudinal data to compare growth patterns (birth to 12 months) and data from two cross-sectional surveys to compare estimates of malnutrition among under-fives.Settings: Bangladesh, Dominican Republic and a pooled sample of infants from North America and Northern Europe.Subjects: Respectively 4787, 10 381 and 226 infants and children.Results: Healthy breast-fed infants tracked along the WHO standard's weight-for-age mean Z-score while appearing to falter on the NCHS reference from 2 months onwards. Underweight rates increased during the first six months and thereafter decreased when based on the WHO standards. For all age groups stunting rates were higher according to the WHO standards. Wasting and severe wasting were substantially higher during the first half of infancy. Thereafter, the prevalence of severe wasting continued to be 1.5 to 2.5 times that of the NCHS reference. The increase in overweight rates based on the WHO standards varied by age group, with an overall relative increase of 34%.Conclusions: The WHO standards provide a better tool to monitor the rapid and changing rate of growth in early infancy. Their adoption will have important implications for child health with respect to the assessment of lactation performance and the adequacy of infant feeding. Population estimates of malnutrition will vary by age, growth indicator and the nutritional status of index populations.