Birth Certificate Linkage To Growth & Health Measures Us

本项目使用第三次全国健康和营养检查调查（NHANES III, 1988- 1984）的数据，与2-83个月样本儿童的出生证明相关联（由Overpeck博士通过与国家卫生和中心/疾病预防控制中心的机构间协议协调），以探索宫内生长对健康的影响。最新的分析集中在母乳喂养和超重、运动和社会发展（MSD）以及幼儿龋齿（ECC）的风险上。有关婴儿喂养和MSD的分析已经完成，并已开始为ECC进行分析。由于母乳喂养对防止超重有保护作用，并且母乳喂养的持续时间有剂量依赖性，因此根据新的NCHS/CDC生长图表的截止值，3-5岁的儿童按体重指数（kg/m2）归类为超重（bbb95百分位数）。调整混杂因素后，没有显著的超重风险（AOR=0.84, 95% CI 0.62-1.13），也没有明显的母乳喂养持续时间的剂量依赖性影响。母乳喂养仍然被强烈推荐，但在防止儿童超重方面，可能不如调节家族因素（如饮食习惯和体育活动）有效。在其他分析中，我们确定了出生体重和胎龄对MSD的独立影响，使用的年龄范围为2-47个月。3%的婴儿和儿童出生时为早产儿，2.2%为足月LBW。调整混杂因素后，早产儿低体重儿童的MSD得分仍然较低（-1.5 +/- 0.3分，p<0.0001），足月低体重儿童的MSD得分也较低（-0.8 +/- 0.4分，p< 0.03）。LBW状态和早产与童年早期MSD的微小但可测量的延迟独立相关。即使对于中度低体重或中度早产的儿童，围产期因素也应与其他已知的发育迟缓危险因素结合起来考虑，以确定是否需要进行临床随访和评估。

This project uses data from the third National Health and Nutrition Examination Survey (NHANES III, 1988-84), linked to birth certificates for sample children ages 2-83 mo (coordinated by Dr. Overpeck through and interagency agreement with NCHS/CDC) to explore the health consequences of intrauterine growth. The latest analyses have focused on breastfeeding and risk of overweight, 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. Since it has been suggested that breastfeeding is protective against overweight and 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 (> 95th percentile) based on cutoffs from the new NCHS/CDC growth charts. Adjusting for confounders, there was no significant risk of being overweight (AOR=0.84, 95% CI 0.62-1.13) and no clear dose-dependent effect of the duration of full breastfeeding. Breastfeeding continues to be strongly recommended, but may not be as effective as moderating familial factors, such as dietary habits and physical activity, in preventing children from becoming overweight. 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 developmental delays in determining the need for clinical follow-up and evaluation.