Postnatal weight loss in term infants: what is ''normal'' and do growth charts allow for it?
Postnatal weight loss in term infants: what is ''normal'' and do growth charts allow for it?
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DOI：
10.1136/adc.2003.026906
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发表时间：
2004-05-01
影响因子：
4.4
通讯作者：
Parkinson, KN
中科院分区：
文献类型：
--
作者：
Wright, CM;Parkinson, KN
背景资料：虽然这是一个众所周知的现象，但关于新生儿体重减轻和随后体重增加的规范性数据有限，因此很难评估个别儿童的长期体重减轻。目的：使用一项基于队列研究的大型前瞻性人群数据，建立出生后体重减轻的规范和限制及其对当前生长参考图的影响。方法：一个队列的961名足月婴儿出生时招募，并采用父母问卷调查和社区护理回报。常规体重收集了一半的队列在5天，所有在12天和6 weeks.Results：体重减轻比以前的研究建议的3-6%，但五分之一的婴儿没有恢复出生体重的12天。那些出生时体重最轻的人体重减轻最少。26名（3%）儿童体重减轻超过10%，但没有显示出重大器质性疾病的证据。实际体重在第一个星期是半到一个百分位数的空间低于生长图表建议，而出生时37周的儿童出生体重百分位数是两个百分位数lower.Conclusions：新生儿体重下降是短暂的，与少数儿童保持低于出生体重的10%以上5天后。生长图表在前2周是误导性的，因为它们没有考虑到新生儿体重减轻。
Background: Although it is a well known phenomenon, limited normative data on neonatal weight loss and subsequent gain are available, making it hard to assess individual children with prolonged weight loss.Objective: To establish, using data from a large prospective population based cohort study, norms and limits for postnatal weight loss and its impact on current growth reference charts.Method: A cohort of 961 term infants were recruited at birth and followed using parental questionnaires and community nursing returns. Routine weights were collected for half the cohort at 5 days and for all at 12 days and 6 weeks.Results: Less weight loss was seen than the 3-6% suggested by previous studies, but one in five infants had not regained their birth weight by 12 days. Those lightest at birth showed least weight loss. Twenty six (3%) children had more than 10% weight loss, but none showed evidence of major organic disease. Actual weights in the first fortnight are half to one centile space lower than growth charts suggest, while birthweight centiles for children born at 37 weeks were two centile spaces lower.Conclusions: Neonatal weight loss is brief, with few children remaining more than 10% below birth weight after 5 days. Growth charts are misleading in the first 2 weeks, because they make no allowance for neonatal weight loss.