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，1988-84）的数据，与年龄2-83个月的样本儿童的出生证明（由Overpeck博士通过与NCHS/CDC的机构间协议协调），以探索宫内生长的健康后果。最新的分析集中在母乳喂养和超重的风险，运动和社会发展（MSD），以及幼儿龋齿（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。由于已经表明母乳喂养可以防止超重，并且其持续时间具有剂量依赖性效应，因此根据新的NCHS/CDC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（>第95百分位数）。调整混杂因素后，超重的风险无显著性（AOR=0.84，95%CI 0.62-1.13），完全母乳喂养的持续时间无明显的剂量依赖性效应。母乳喂养仍然是强烈推荐的，但在防止儿童超重方面，母乳喂养可能不如饮食习惯和体育活动等家庭因素有效。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分，p<0.0001），足月LBW儿童也是如此（-0.8 +/-0.4分，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迟缓风险因素。

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.