Background:The fetal growth charts in widest use in China were published by Hadlock>35 years ago and were established on data from several hundred of American pregnant women.After that,>100 fetal growth charts w...Background:The fetal growth charts in widest use in China were published by Hadlock>35 years ago and were established on data from several hundred of American pregnant women.After that,>100 fetal growth charts were published around the world.We attempted to assess the impact of applying the long-standing Hadlock charts and other charts in a Chinese population and to compare their ability to predict newborn small for gestational age(SGA).Methods:For this retrospective observational study,we reviewed all pregnant women(n=106,455)who booked prenatal care with ultrasound measurements for fetal biometry at the Shenzhen Maternity and Child Healthcare Hospital between 2012 and 2019.A fractional polynomial regression model was applied to generate Shenzhen fetal growth chart ranges for head circumference(HC),biparietal diameter(BPD),abdominal circumference(AC),and femur length(FL).The differences between Shenzhen charts and published charts were quantified by calculating the Z-score.The impact of applying these published charts was quantifed by calculating the proportions of fetuses with biometric measurements below the 3rd centile of these charts.The sensitivity and area under the receiver operating characteristic curves of published charts to predict neonatal SGA(birthweight<10th centile)were assessed..Results:Following selection,169,980 scans of fetal biometry contributed by 41,032 pregnancies with reliable gestational age were analyzed.When using Hadlock references(<3rd centile),the proportions of small heads and short femurs were as high as 8.9%and 6.6%in late gestation,respectively.The INTERGROWTH-21st standards matched those of our observed curves better than other charts,in particular for fat-free biometry(HC and FL).When using AC<10th centile,all of these references were poor at predicting neonatal SGA.Conclusions:Applying long-standing Hadlock references could misclassify a large proportion of fetuses as SGA.INTERGROWTH-21st standard appears to be a safe option in China.For fat-based biometry,AC,a reference based on the Chinese population is needed.In addition,when applying published charts,particular care should be taken due to the discrepancy of measurement methods.展开更多
Mental disorders are common health concerns and contribute to a heavy global burden on our modern society.It is challenging to identify and treat them timely.Neuroimaging evidence suggests the incidence of various psy...Mental disorders are common health concerns and contribute to a heavy global burden on our modern society.It is challenging to identify and treat them timely.Neuroimaging evidence suggests the incidence of various psychiatric and behavioral disorders is closely related to the atypical development of brain structure and function.The identification and understanding of atypical brain development provide chances for clinicians to detect mental disorders earlier,perhaps even prior to onset,and treat them more precisely.An invaluable and necessary method in identifying and monitoring atypical brain development are growth charts of typically developing individuals in the population.The brain growth charts can offer a series of standard references on typical neurodevelopment,representing an important resource for the scientific and medical communities.In the present paper,we review the relationship between mental disorders and atypical brain development from a perspective of normative brain development by surveying the recent progress in the development of brain growth charts,including four aspects on growth chart utility:1)cohorts,2)measures,3)mechanisms,and 4)clinical translations.In doing so,we seek to clarify the challenges and opportunities in charting brain growth,and to promote the application of brain growth charts in clinical practice.展开更多
Introduction: Current WHO recommendation is to continue exclusive breast feeding (EBF) up to six months. Main concern regarding this recommendation is, whether EBF supports rapidly growing infant with adequate nutriti...Introduction: Current WHO recommendation is to continue exclusive breast feeding (EBF) up to six months. Main concern regarding this recommendation is, whether EBF supports rapidly growing infant with adequate nutrition. Methods: A cohort of randomly selected new-borns was followed up at two, four and six months, to study feeding pattern and physical growth. Feeding practices and socio-demographic data were collected using an interviewer administered questionnaire. Weight & length were measured using standard techniques. Results: EBF rates were very high in this cohort of children. One main reason to stop EBF was growth faltering. Only some children showed a catch up growth by stopping EBF. At two, four and six months, weight faltering rates among EBF babies were, 11.1%, 20.1% and 13.2% respectively. Length faltering had a similar pattern, but with a higher rate at all ages. Conclusions: EBF up to six months did not cause growth faltering in the majority. In the majority, no identifiable cause for growth faltering was found. Possible genetic influence on growth faltering was not considered when stopping EBF.展开更多
Background INTERGROWTH-21 st Newborn Cross-Sectional Study(NCSS)charts were established and recommended for global application.However,whether one international reference is appropriate for all populations is still un...Background INTERGROWTH-21 st Newborn Cross-Sectional Study(NCSS)charts were established and recommended for global application.However,whether one international reference is appropriate for all populations is still unclear.We aim to compare the updated Chinese birth size charts by gestational age with INTERGROWTH-21st NCSS charts.Methods A cross-sectional survey was carried out,and the birth weight,length and head circumference of 24,375 infants born after uncomplicated pregnancies at gestational age ranging from 24+0 to 42+6 weeks were measured in 13 cities in China from 2015 to 2018.Growth charts were constructed.The measurements of all these infants were evaluated by the methods of calculating their Z scores using the INTERGROWTH-21 st standards.The prevalence of small for gestational age(SGA)and large for gestational age(LGA)based on birth weight was analyzed using Chinese charts and INTERGROWTH-21st charts.Results The mean Z scores were 0.10 for birth weight,0.35 for length and-0.02 for head circumference.Compared to the INTERGROWTH-21st charts,the Chinese birth weight percentile curves were higher except for the 90th percentile at 29-37 weeks gestational age,and the length percentile curves were higher after 33 weeks gestational age,while the 10th percentile of the head circumference was lower and the other percentiles were similar.The prevalence of SGA was 10.1%[95%confidence interval(CI)=9.7%-10.5%]using the Chinese birth weight chart and 6.5%(95%CI=6.2%-6.8%)using the INTERGROWTH-21 st birth weight chart.The prevalence of LGA was 9.9%(95%CI=9.5%-10.2%)and 8.2%(95%CI=7.9%-8.6%)using the Chinese and INTERGROWTH-21st birth weight charts,respectively.Conclusions Chinese birth size charts based on infants born after uncomplicated pregnancies were different from the INTER-GROWTH-21st charts.Differences in the classification of newborns by the two charts should receive attention,and whether the application of INTERGROWTH-21st in Chinese newborns will lead to misclassification needs to be validated in future clinical practice.展开更多
目的探究儿童肾移植术后生长趋势以及激素撤除对于生长曲线的影响。方法回顾性分析2013年5月至2021年3月于郑州大学第一附属医院肾移植科接受肾移植手术的儿童受者临床资料,术后采用他克莫司+霉酚酸+糖皮质激素(glucocorticoid,GC)三联...目的探究儿童肾移植术后生长趋势以及激素撤除对于生长曲线的影响。方法回顾性分析2013年5月至2021年3月于郑州大学第一附属医院肾移植科接受肾移植手术的儿童受者临床资料,术后采用他克莫司+霉酚酸+糖皮质激素(glucocorticoid,GC)三联免疫治疗方案,根据术后3个月内是否撤除激素分为撤激素组和未撤激素组,观察两组各时间段内生长发育变化情况,比较两组在撤除激素前后各时间段生长变化速率的差异。结果共214例患儿纳入研究,其中未撤激素组142例,撤激素组72例;两组术前身高年龄别评分(height for age Z-score,HAZ评分)分别为(-1.60±1.48)分和(-1.44±1.38)分,差异无统计学意义(P=0.539);术后1年时两组HAZ评分分别为(-0.95±1.31)分和(-0.51±1.10)分,差异具有统计学意义(P=0.046)。两组术前、术后3个月、术后6个月的HAZ评分差异均无统计学意义(P>0.05)。两组手术后前3个月、手术后3~6个月HAZ评分的变化速率差异均无统计学意义(P>0.05),而手术后6~12个月的差异具有统计学意义(P=0.016)。结论慢性终末期肾病(end-stage renal disease,ESRD)患儿术前存在不同程度的发育迟缓,接受肾移植后患儿生长缺陷有所弥补,术后不同时间段身高发育速率有所不同,在术后追赶性生长的高峰期到来之前撤除激素对于儿童手术后远期发育有积极的影响。展开更多
基金supported by grants from the Shenzhen Science and Technology Project(No.JCYJ20210324130812035)The National Key Research and Development Program of China(No.2018YFC1002200).
文摘Background:The fetal growth charts in widest use in China were published by Hadlock>35 years ago and were established on data from several hundred of American pregnant women.After that,>100 fetal growth charts were published around the world.We attempted to assess the impact of applying the long-standing Hadlock charts and other charts in a Chinese population and to compare their ability to predict newborn small for gestational age(SGA).Methods:For this retrospective observational study,we reviewed all pregnant women(n=106,455)who booked prenatal care with ultrasound measurements for fetal biometry at the Shenzhen Maternity and Child Healthcare Hospital between 2012 and 2019.A fractional polynomial regression model was applied to generate Shenzhen fetal growth chart ranges for head circumference(HC),biparietal diameter(BPD),abdominal circumference(AC),and femur length(FL).The differences between Shenzhen charts and published charts were quantified by calculating the Z-score.The impact of applying these published charts was quantifed by calculating the proportions of fetuses with biometric measurements below the 3rd centile of these charts.The sensitivity and area under the receiver operating characteristic curves of published charts to predict neonatal SGA(birthweight<10th centile)were assessed..Results:Following selection,169,980 scans of fetal biometry contributed by 41,032 pregnancies with reliable gestational age were analyzed.When using Hadlock references(<3rd centile),the proportions of small heads and short femurs were as high as 8.9%and 6.6%in late gestation,respectively.The INTERGROWTH-21st standards matched those of our observed curves better than other charts,in particular for fat-free biometry(HC and FL).When using AC<10th centile,all of these references were poor at predicting neonatal SGA.Conclusions:Applying long-standing Hadlock references could misclassify a large proportion of fetuses as SGA.INTERGROWTH-21st standard appears to be a safe option in China.For fat-based biometry,AC,a reference based on the Chinese population is needed.In addition,when applying published charts,particular care should be taken due to the discrepancy of measurement methods.
基金supported by the Child Brain-Mind Development Cohort Study in China Brain Initiative(SQ2021AAA010024)the Start-up Funds for Leading Talents at Beijing Normal University,the National Basic Science Data Center“Chinese Data-sharing Warehouse for In-vivo Imaging Brain”(NBSDC-DB-15)+2 种基金the Beijing Municipal Science and Technology Commission(Z161100002616023)the Major Project of National Social Science Foundation of China(20&ZD296)Dr Avram J.Holmes is supported by the National Institutes of Health(R01MH120080).
文摘Mental disorders are common health concerns and contribute to a heavy global burden on our modern society.It is challenging to identify and treat them timely.Neuroimaging evidence suggests the incidence of various psychiatric and behavioral disorders is closely related to the atypical development of brain structure and function.The identification and understanding of atypical brain development provide chances for clinicians to detect mental disorders earlier,perhaps even prior to onset,and treat them more precisely.An invaluable and necessary method in identifying and monitoring atypical brain development are growth charts of typically developing individuals in the population.The brain growth charts can offer a series of standard references on typical neurodevelopment,representing an important resource for the scientific and medical communities.In the present paper,we review the relationship between mental disorders and atypical brain development from a perspective of normative brain development by surveying the recent progress in the development of brain growth charts,including four aspects on growth chart utility:1)cohorts,2)measures,3)mechanisms,and 4)clinical translations.In doing so,we seek to clarify the challenges and opportunities in charting brain growth,and to promote the application of brain growth charts in clinical practice.
文摘Introduction: Current WHO recommendation is to continue exclusive breast feeding (EBF) up to six months. Main concern regarding this recommendation is, whether EBF supports rapidly growing infant with adequate nutrition. Methods: A cohort of randomly selected new-borns was followed up at two, four and six months, to study feeding pattern and physical growth. Feeding practices and socio-demographic data were collected using an interviewer administered questionnaire. Weight & length were measured using standard techniques. Results: EBF rates were very high in this cohort of children. One main reason to stop EBF was growth faltering. Only some children showed a catch up growth by stopping EBF. At two, four and six months, weight faltering rates among EBF babies were, 11.1%, 20.1% and 13.2% respectively. Length faltering had a similar pattern, but with a higher rate at all ages. Conclusions: EBF up to six months did not cause growth faltering in the majority. In the majority, no identifiable cause for growth faltering was found. Possible genetic influence on growth faltering was not considered when stopping EBF.
基金This project was supported by the National Health Commission of the People's Republic of China(No.2015-42).
文摘Background INTERGROWTH-21 st Newborn Cross-Sectional Study(NCSS)charts were established and recommended for global application.However,whether one international reference is appropriate for all populations is still unclear.We aim to compare the updated Chinese birth size charts by gestational age with INTERGROWTH-21st NCSS charts.Methods A cross-sectional survey was carried out,and the birth weight,length and head circumference of 24,375 infants born after uncomplicated pregnancies at gestational age ranging from 24+0 to 42+6 weeks were measured in 13 cities in China from 2015 to 2018.Growth charts were constructed.The measurements of all these infants were evaluated by the methods of calculating their Z scores using the INTERGROWTH-21 st standards.The prevalence of small for gestational age(SGA)and large for gestational age(LGA)based on birth weight was analyzed using Chinese charts and INTERGROWTH-21st charts.Results The mean Z scores were 0.10 for birth weight,0.35 for length and-0.02 for head circumference.Compared to the INTERGROWTH-21st charts,the Chinese birth weight percentile curves were higher except for the 90th percentile at 29-37 weeks gestational age,and the length percentile curves were higher after 33 weeks gestational age,while the 10th percentile of the head circumference was lower and the other percentiles were similar.The prevalence of SGA was 10.1%[95%confidence interval(CI)=9.7%-10.5%]using the Chinese birth weight chart and 6.5%(95%CI=6.2%-6.8%)using the INTERGROWTH-21 st birth weight chart.The prevalence of LGA was 9.9%(95%CI=9.5%-10.2%)and 8.2%(95%CI=7.9%-8.6%)using the Chinese and INTERGROWTH-21st birth weight charts,respectively.Conclusions Chinese birth size charts based on infants born after uncomplicated pregnancies were different from the INTER-GROWTH-21st charts.Differences in the classification of newborns by the two charts should receive attention,and whether the application of INTERGROWTH-21st in Chinese newborns will lead to misclassification needs to be validated in future clinical practice.
文摘目的探究儿童肾移植术后生长趋势以及激素撤除对于生长曲线的影响。方法回顾性分析2013年5月至2021年3月于郑州大学第一附属医院肾移植科接受肾移植手术的儿童受者临床资料,术后采用他克莫司+霉酚酸+糖皮质激素(glucocorticoid,GC)三联免疫治疗方案,根据术后3个月内是否撤除激素分为撤激素组和未撤激素组,观察两组各时间段内生长发育变化情况,比较两组在撤除激素前后各时间段生长变化速率的差异。结果共214例患儿纳入研究,其中未撤激素组142例,撤激素组72例;两组术前身高年龄别评分(height for age Z-score,HAZ评分)分别为(-1.60±1.48)分和(-1.44±1.38)分,差异无统计学意义(P=0.539);术后1年时两组HAZ评分分别为(-0.95±1.31)分和(-0.51±1.10)分,差异具有统计学意义(P=0.046)。两组术前、术后3个月、术后6个月的HAZ评分差异均无统计学意义(P>0.05)。两组手术后前3个月、手术后3~6个月HAZ评分的变化速率差异均无统计学意义(P>0.05),而手术后6~12个月的差异具有统计学意义(P=0.016)。结论慢性终末期肾病(end-stage renal disease,ESRD)患儿术前存在不同程度的发育迟缓,接受肾移植后患儿生长缺陷有所弥补,术后不同时间段身高发育速率有所不同,在术后追赶性生长的高峰期到来之前撤除激素对于儿童手术后远期发育有积极的影响。
