WHO MULTICENTER GROWTH REFERENCE STUDY: U.S. SITE

评估婴儿/儿童成长是监测的一个关键因素 营养状况和评估各种方案的影响。 最近，世界卫生组织“身体状况：使用和使用”专家委员会 对人体测量学的解释引发了对以下几个问题的严重关注 当前NCHS-WHO生长参考的局限性，其中包括 事实上，健康的母乳喂养婴儿的生长表现出不同的 弹道。委员会建议设立一名新的国际 可供参考。因此，世卫组织发起了一个多中心 增长参考研究将于年内在6至8个地点进行 不同的大陆。在每个国家，这项研究将包括一个 从出生到24个月的纵向设计和横截面 该组件适用于18-59个月大的儿童。18和18之间的重叠部分 24个月将有助于合并这两条曲线。这项研究将是 基于符合几个选择的母婴样本 标准(例如较高的社会经济地位)；纵向 这些内容将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， 在4-6个月内引入适当的补充食物，以及 此后部分母乳喂养，直至至少12个月大)。这个 世卫组织多中心增长参考研究的协调员 将我们的位置(加利福尼亚州戴维斯)确定为美国网站的理想选择， 因为我们社区的母乳喂养率很高，我们的 进行此类研究的经验。这项提案寻求资金用于 在该站点收集纵向组件的数据。为了这个 组件(N=180，其中至少70个将保持合格和完整 整整24个月)，受试者将在 分娩并在第1、2、4和6周进行访问，每月2-12个月和 每两个月一次，从12点到24点。人体测量将包括儿童体重， 长度、头围和臂围，以及三头肌和肩胛下肌 皮褶厚度，以及父母的体重和身高。其他数据将是 关于围产期社会经济和人口特征的收集 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次 测量的百分比，并定期召开中心间协调会议。 世卫组织将汇集这些数据，以创建新的生长参考， 适用于国际范围内的所有婴幼儿。

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.