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个月样本儿童的出生证明（由Overpeck博士通过与NCHS/CDC的机构间协议进行协调），以探讨宫内生长的健康后果。 最新的分析集中在母乳喂养，运动和社会发展（MSD）和幼儿龋齿（ECC）。 已完成与婴儿喂养和默沙东相关的分析，并已启动ECC分析。 我们探讨了纯母乳喂养4个月的婴儿是否与其他方式喂养的婴儿在体型上存在差异，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<0.05），但与早期婴儿喂养相关的第一年后的生长几乎没有显著差异。 由于也有人认为母乳喂养可以防止儿童超重，并且母乳喂养的持续时间具有剂量依赖性效应，因此根据新的NCHS生长图表的截止值，将3-5岁的儿童按体重指数（kg/m2）归类为超重（OW 95，>第95百分位数）。 调整混杂因素后，OW 95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没有明显的剂量依赖性效应。母乳喂养仍然是强烈建议的，但可能不是预防幼儿期超重的主要指标。 在其他分析中，我们使用2-47个月的适合年龄的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和2.2%的足月LBW。 调整混杂因素后，早产LBW儿童的MSD评分仍然较低（-1.5？0.3点，p<0.0001），足月LBW儿童（-0.8？0.4点，p<0.03）。 LBW状态和早产独立地与小，但可测量的延迟MSD通过幼儿期。 即使对于中度LBW或中度早产的儿童，在确定是否需要临床随访和评估时，也应考虑围产期因素与其他已知的发育延迟风险因素。

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.