BIRTH CERTIFICATE LINKAGE TO GROWTH & HEALTH MEASURES US

该项目使用第三次全国健康和营养检查调查(NHANES III，1988-94)的数据，与2-83个月的样本儿童的出生证明(由Overpek博士通过与NCHS/CDC的机构间协议协调)相关联，以探讨胎儿宫内发育的健康后果。最新的分析侧重于母乳喂养、运动和社会发展(MSD)以及幼儿龋齿(ECC)。已经完成了与婴儿喂养和MSD有关的分析，并启动了针对ECC的分析。我们讨论了纯母乳喂养4个月的婴儿与其他喂养方式的婴儿在体型上是否存在差异，以及这种差异是否持续到5岁。虽然纯母乳喂养4个月的婴儿在8-11个月时体重较轻(p&lt；0.05)，但第一年后的生长与早期婴儿喂养几乎没有显著差异。由于母乳喂养对儿童超重也有保护作用，而且持续时间存在剂量依赖效应，根据新的NCHS生长图表的截止点，3-5岁的儿童根据体重指数(kg/m2)被归类为超重(OW95；&gt；95%)。调整混杂因素后，OW95的风险没有显著降低(AOR=0.90，95%CI=0.67-1.21)，完全母乳喂养的持续时间也没有明显的剂量依赖效应。母乳喂养仍然是强烈建议的，但可能不是预防儿童早期超重的领先指标。在其他分析中，我们使用2-47mo的年龄适宜量表，确定了出生体重和胎龄对MSD的独立影响。3%的婴儿和儿童早产LBW，2.2%的足月LBW。调整混杂因素后，早产儿的MSD值仍较低(-1.5±0.3分，P<0.0001.0 5)，足月儿(-0.8±0.4分，P<0.0 3)。LBW状态和早产与MSD在儿童早期的微小但可测量的延迟独立相关。即使对于仅有中度LBW或中度早产的儿童，在确定是否需要临床随访和评估时，也应将围产期因素与其他已知的发育延迟风险因素结合起来考虑。

This project uses data from the third National Health and Nutrition Examination Survey (NHANES III, 1988-94), linked to birth certificates for sample children ages 2-83 mo (coordinated by Dr. Overpeck through an interagency agreement with NCHS/CDC) to explore the health consequences of intrauterine growth. The latest analyses have focused breast-feeding, motor and social development (MSD), and early childhood caries (ECC). Analyses have been completed related to infant feeding and MSD, and have been initiated for ECC. We addressed whether infants exclusively breast-fed for 4 mo differed in size from infants fed other ways, and whether such differences persist through age 5 y. While infants exclusively breast-fed for 4 mo weighed less at 8-11 mo (p<0.05), there were few significant differences in growth after the first year related to early infant feeding. Since it has also been suggested that breast-feeding is protective against overweight in children and that there is a dose-dependent effect of its duration, children ages 3-5 y were categorized by body mass index (kg/m2) as being overweight (OW95, > 95th percentile) based on cutoffs from the new NCHS growth charts. Adjusting for confounders, there was no significant reduced risk of being OW95 (AOR=0.90, 95% CI=0.67-1.21) and no clear dose-dependent effect of the duration of full breast-feeding. Breast-feeding continues to be strongly recommended, but may not be a leading indicator for the prevention of overweight in early childhood. In other analyses, we determined the independent effects of birth weight and gestational age on MSD, using an age-appropriate scale from 2-47 mo. Three percent of the infants and children were born preterm LBW and 2.2% term LBW. Adjusting for confounders, preterm LBW children still had lower MSD scores (-1.5?0.3 points, p<0.0001), as did term LBW children (-0.8?0.4 points, p<0.03). LBW status and preterm delivery were associated independently with small, but measurable delays in MSD through early childhood. Even for children only moderately LBW or moderately preterm, perinatal factors should be considered in association with other known risk factors for development delays in determining the need for clinical follow-up and evaluation.