WHO Child Growth Standards based on length/height, weight and age
WHO Child Growth Standards based on length/height, weight and age
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DOI：
10.1080/08035320500495548
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发表时间：
2006-04-01
期刊：
影响因子：
3.8
通讯作者：
Lartey, Anna
中科院分区：
文献类型：
--
作者：
de Onis, Mercedes;Martorell, Reynaldo;Lartey, Anna
目的：描述用于构建基于身高/身高、体重和年龄的WHO儿童生长标准的方法，并提供生成的生长图表。研究方法：世卫组织儿童生长标准是从在不限制生长的环境中长大的健康母乳喂养婴儿和幼儿的国际样本中得出的。各研究中心严格的数据收集方法和标准化程序产生了非常高质量的数据。标准的制定遵循了有条不紊的最新统计方法。Box-Cox幂指数（BCPE）方法，用三次样条曲线平滑，用于构建曲线。BCPE适应各种类型的分布，从正态到偏态或峰度，如有必要。使用一组诊断工具来检测估计的偏差或z评分曲线中可能存在的偏差。结果：三次样条函数实现最佳模型所需的自由度有很大的变化。除年龄别身高/身高符合正态分布外，所有其他标准都需要对偏度进行建模，而不是峰度。通过拟合反映这两个测量值之间0.7 cm平均差异的独特模型，构建了年龄别身高和年龄别身高标准。平滑百分位数曲线和经验曲线之间的一致性非常好，没有偏倚。针对年龄别体重、年龄别身长/身高、身长别体重/身高八项指标，生成0-60个月男孩和女孩的百分位数和z评分曲线（分别为45至110 cm和65至120 cm）和体重指数。世卫组织儿童生长标准描述了在最佳环境条件下的正常生长，可用于评估世界各地的儿童，无论其种族如何，社会经济地位和喂养方式。
Aim: To describe the methods used to construct the WHO Child Growth Standards based on length/height, weight and age, and to present resulting growth charts. Methods: The WHO Child Growth Standards were derived from an international sample of healthy breastfed infants and young children raised in environments that do not constrain growth. Rigorous methods of data collection and standardized procedures across study sites yielded very high-quality data. The generation of the standards followed methodical, state-of-the-art statistical methodologies. The Box-Cox power exponential (BCPE) method, with curve smoothing by cubic splines, was used to construct the curves. The BCPE accommodates various kinds of distributions, from normal to skewed or kurtotic, as necessary. A set of diagnostic tools was used to detect possible biases in estimated percentiles or z-score curves. Results: There was wide variability in the degrees of freedom required for the cubic splines to achieve the best model. Except for length/height-for-age, which followed a normal distribution, all other standards needed to model skewness but not kurtosis. Length-for-age and height-for-age standards were constructed by fitting a unique model that reflected the 0.7-cm average difference between these two measurements. The concordance between smoothed percentile curves and empirical percentiles was excellent and free of bias. Percentiles and z-score curves for boys and girls aged 0-60 mo were generated for weight-for-age, length/height-for-age, weight-for-length/h eight (45 to 110 cm and 65 to 120 cm, respectively) and body mass index-for-age.Conclusion: The WHO Child Growth Standards depict normal growth under optimal environmental conditions and can be used to assess children everywhere, regardless of ethnicity, socio-economic status and type of feeding.