WHO MULTICENTER GROWTH REFERENCE STUDY: U.S. SITE

婴儿/儿童成长评估是监测的一个关键要素 营养状况并评估各种计划的影响。 最近，世界卫生组织专家委员会的“身体状况：使用和 对人体测量学的解释”引起了对几个问题的严重关切， 目前NCHS-WHO增长参考的局限性，其中包括 事实上，健康的母乳喂养婴儿的成长表现出不同的 弹道 委员会建议， 参考开发。 因此，世卫组织启动了一项多中心 在六至八个地点进行生长参考研究 不同的大陆。 在每个国家，研究将包括一个 从出生到24个月的纵向设计和横截面设计 为18-59个月的儿童提供的组件。18和19之间的重叠 24个月将有助于合并两条曲线。 本研究将 根据符合几项选择的母亲和婴儿的样本， 标准（如社会经济地位高）;纵向 其中包括遵守婴儿喂养建议 （纯母乳喂养或主要母乳喂养至少4个月， 从4-6个月开始引入适当的辅食， 此后部分母乳喂养，直到至少12个月大）。 的 世卫组织多中心生长参考研究的协调员 将我们的位置（加利福尼亚州戴维斯）确定为美国站点的理想选择， 由于我们社区的母乳喂养率很高， 进行此类研究的经验。 该提案寻求资金， 在该站点收集纵向分量的数据。 为此 组成部分（N=180，其中至少70人将保持合格并完成 整个24个月），受试者将在 分娩，并在第1、2、4和6周时进行访视，从2-12个月每月一次， 每两个月一次，从12-24个月。人体测量将包括儿童体重， 长度、头围和臂围、三头肌和肩胛下肌 皮褶厚度父母的体重和身高 其他数据将 根据社会经济和人口统计学特征、围产期 因素、发病率和饮食摄入量。 质量控制将得到保证 通过定期的标准化会议，随机重复5-10 %的测量，并定期举行中心间协调会议。 世卫组织将汇总这些数据，以创建一个新的增长参考， 适用于国际上所有婴儿和儿童。

Assessment of infant/child growth is a key element of monitoring nutritional status and evaluating the impact of various programs. Recently, the WHO Expert Committee of "Physical Status: Uses and Interpretation of Anthropometry" raised serious concerns about several limitations of the current NCHS-WHO growth reference, among them the fact that growth of healthy, breastfed infants shows a different trajectory. The Committee recommended that a new international reference be developed. As a result, WHO has initiated a Multicentre Growth Reference Study to be conducted at six to eight sites in different continents. In each country, the study will include a longitudinal design from birth to 24 months and a cross-sectional component for children 18-59 months of age. The overlap between 18 and 24 months will be useful for merging the two curves. The study will be based on samples of mothers and infants who meet several selection criteria (e.g. high socioeconomic status); for the longitudinal component these will include adherence to infant feeding recommendations (exclusive or predominant breastfeeding for at least 4 months, introduction of appropriate complementary foods from 4-6 months, and partial breastfeeding thereafter until at least 12 months of age). The coordinators of the WHO Multicentre Growth Reference Study have identified our location (Davis, CA) as an ideal choice for a U.S. site, because of the high rate of breastfeeding in our community and our experience in conducting such studies. This proposal seeks funding for data collection for the longitudinal component at this site. For this component (N=180, of whom at least 70 will remain eligible and complete the entire 24 months), subjects will be recruited at the time of delivery and visited at 1,2,4 and 6 weeks, monthly from 2-12 mo and bimonthly from 12-24 mo. Anthropometry will include child weight, length, head and arm circumferences, and triceps and subscapular skinfold thickness, and parents' weight and height. Other data will be collected on socioeconomic and demographic characteristics, perinatal factors, morbidity, and dietary intake. Quality control will be assured through regular standardization sessions, random repetition of 5-10 percent of measurements, and regular inter-center coordination meetings. The data will be pooled by WHO to create a new growth reference, applicable to all infants and children internationally.