BIRTH CERTIFICATE LINKAGE TO GROWTH & HEALTH MEASURES USING NHANESIII

第三次全国健康和营养检查调查（NHANESIII）收集了描述性数据，物理措施，和生物医学样本（血液和尿液）的代表性美国儿童样本在两个月到六岁的黑人和墨西哥裔美国人的过度采样。测量血清可替宁水平，并获得产前母亲吸烟的信息。NICHD支持从各州获取出生证明，并协调出生率数据与NHANESIII测量结果的联系。NCHS向NICHD提交了出生率和生长指标文件。这种联系的结果正在用于以下研究工作：1）确定低出生体重或早产儿是否随后健康状况不佳，这是通过对6岁以下儿童的代表性全国样本进行生物医学标记来衡量的; 2）评估民族/种族和社会经济因素对这些结果的影响; 3）根据出生时的风险状况，为美国代表性人口以及黑人和墨西哥裔美国儿童制定规范性生长和其他生物医学量表;（4）比较母亲和代理人关于儿童出生时风险因素的报告与其他研究中使用的实际测量数据。研究结果包括：1）出生体重对生长的显著影响持续到前六岁，p<0.001。低出生体重（LBW）儿童的相对不足和高出生体重（HBW）儿童的过度是更大的线性措施（长度和高度）和措施的肌肉和瘦体重比皮下脂肪的措施。对于长度/身高、上臂和大腿肌肉面积，LBW儿童在6岁之前比正常（NBW）体重儿童的平均值低0.5个标准差。HBW儿童高于平均值0.4个标准差。2)暴露于环境烟草烟雾（ETS）约占2个月至5岁儿童呼吸道疾病的40-60%。ETS暴露增加了两个月至两岁奥尔兹慢性支气管炎和喘息的患病率，并增加了所有年龄段的哮喘患病率。对于家庭暴露，只有在每天吸烟20支以上时才观察到一致的影响。3)在出生时体重合适和足月妊娠的儿童中，2-6岁的墨西哥裔美国儿童的体重指数（BMI）大于非西班牙裔白人。黑人女性也是如此。黑人女性在2-5岁之间的BMI并没有像其他儿童那样下降; 4）在2-5岁的纯母乳喂养、纯配方奶粉喂养或部分母乳喂养的儿童中，肥胖和肌肉发达程度没有差异。- 儿童生长，胎龄出生体重，全国调查

The third National Health and Nutrition Examination Survey (NHANESIII) collected descriptive data, physical measures, and biomedical samples (blood and urine) on a representative U.S. sample of children at ages two months through six years with over sampling for Blacks and Mexican Americans. Serum cotinine levels were measured and information on prenatal maternal smoking obtained. NICHD supported acquisition of birth certificates from the States and coordinated linkage of the natality data to NHANESIII measurements. Files with natality and growth measures were delivered to NICHD by NCHS. Results of the linkage are being used in research efforts on the following: 1) to determine if low birth weight or premature children have subsequent poor health as measured by biomedical markers in a representative national sample of children through age six; 2) to assess the effects of ethnic/racial and socioeconomic factors on these outcomes; 3) to develop normative growth and other biomedical scales for a U.S. representative population, and Black and Mexican-American children,according to a risk profile at birth; and 4) to develop comparisons between maternal and proxy reports of childrens risk factors at birth and actual measurements for use in other studies. Findings include the following: 1) Significant effects of birth weight on growth persist through the first six years of age at p<0.001. The relative deficits for low birth weight (LBW) children and excesses for high birth weight (HBW) children are larger for linear measures length and height) and measures of muscularity and lean body mass than measures of subcutaneous fatness. For length/height, upper arm and thigh muscle areas, LBW children were 0.5 standard deviations below the mean for normal (NBW) weight children through age six. HBW children were 0.4 standard deviations above the mean. 2) Exposure to environmental tobacco smoke (ETS) accounts for approximately 40-60% of respiratory morbidity in children ages two months to five years. ETS exposure increased the prevalence of chronic bronchitis and wheezing among two months to two year olds and asthma across all ages. For household exposure, a consistent effect was seen only at 20+ cigarettes a day. 3) In children born with appropriate weights and term gestation, body mass index (BMI) Mexican-American children ages 2-6 years was greater than for non-Hispanic whites. The same was true for black females. BMI did not decrease for black females between ages 2-5 as it did for other children; 4) Fatness and muscularity did not differ among children at ages 2-5 years who were either exclusively breastfed, exclusively formula fed or partially breastfed. - childhood growth, birth weight for gestational age, national survey