农村母乳喂养0～12月龄婴儿体格生长百分位曲线研究

Growth curves for breastfed infants in rural areas

目的制定农村母乳喂养婴儿0～12月龄年龄别体重、身长和头围的百分位参考值及生长曲线图。方法应用“中国母乳喂养婴儿生长速率监测及标准值研究”中农村母乳喂养婴儿0～12月龄体格发育纵向随访数据，采用MLwiN2．25构建各生长指标多水平模型，估计预测值，拟合百分位曲线，与2005年中国九市7岁以下儿童体格发育调查结果和世界卫生组织（WHO）2006年儿童生长标准比较。结果制定出农村母乳喂养婴儿0～12月龄百分位生长曲线图。与中国九市调查结果相比，在尸3百分位曲线上，男、女童年龄别体重和女童年龄别身长分别高0．02～0．39kg、0～0．42kg和0．27～1．15cm；与WHO儿童生长标准相比，本研究人群各项指标的Jp3百分位曲线均处于较高水平。在农村使用九市儿童生长参考值可能会降低低体重婴儿以及女童生长迟缓检出率；使用WHO儿童生长标准也可能会降低低体重婴儿检出率。结论本研究结果来源于纵向数据，能够更为科学反映婴儿生长发育状况，可用于农村母乳喂养婴儿生长发育评价和指导。

Objective To construct the growth percentile curves of weight, length and head circumference-for-age for breastfeed infants in rural areas, and take them as the reference standards to evaluate growth of breastfed infants in rural areas. Method The data collected in the Longitudinal Study of Chinese Breastfed Infants Growth and Development from birth to 12 months of age in 6 well-being rural areas were used. The MLwiN2. 25 was selected to construct the multilevel model to estimate the predicted values, and fit the percentiles reference curves （/＇3, P15, PS0, P85, and P97） of weight, length and head circunfference-for-age. The results of this study were compared with those of the Nine-city growth reference percentiles curves in China and with WHO growth reference percentiles curves. Result The percentiles reference curves of weight, length and head circumference-for-age for breastfeeding infants aged 0 - 12 months in rural areas were developed. Compared with the Nine-city growth reference, the P3 curves of weight-for-age and girls＇ length-for-age were higher by O. 02 - 0. 39 kg, 0 - O. 42 kg and 0.27 - 1.15 cm. Compared with the WHO growth reference, the P3 curves of boys and girls were both at a high level. It was estimated that using Nine-city growth reference percentiles curves to evaluate the infants in rural areas could reduce the rates of underweight and girls＇ stunting; and using WHO growth reference percentiles curves could reduce all infants＇ underweight rates. Conclusion The growth percentiles reference curves which wereconstructed by the longitudinal observational data and scientific method would have great significance in reflecting the development of breastfed infants, evaluating and guiding infants＇ growth in rural areas.