目的研究制定中国24~42周出生胎龄新生儿出生体重、身长和头围的生长参照标准及曲线，供临床及相关领域研究工作使用。
方法于2015年6月至2018年11月采用整群抽样方法，调查北京、哈尔滨、西安、上海、南京、武汉、广州、福州、昆明等城市24~42周出生胎龄的新生儿24 375名。采用基于位置、尺度、形状的广义可加模型（GAMLSS）建立24~42周出生胎龄男、女新生儿的出生体重、身长和头围的百分位参照标准及曲线。将制定的参照标准与我国1988年参照值及国际Fenton2013参照值进行比较。
结果受调查新生儿中早产儿12 264名、足月儿12 111名。采用男新生儿13 197名（54.1%）、女新生儿11 178名（45.9%）制定出了出生胎龄24~42周的男、女新生儿出生体重、身长和头围的百分位数（P） 3、P 10、P 25、P 50、P 75、P 90和P 97参照值和曲线图，3项指标均随出生胎龄增加呈增长趋势，出生胎龄37周以后生长速率略有下降，如男新生儿28、32、37、40周出生胎龄体重的中位数依次为1 154、1 805、2 943和3 455 g。各个出生胎龄组男新生儿出生体重、身长和头围的生长水平分别比女新生儿高87~133 g、0.2~0.9 cm和0.3~0.6 cm。本研究男、女出生胎龄37~42周新生儿出生体重P 10、P 50、P 90均明显高于1988年参照值（如男P 50高115~242 g）。本研究出生胎龄33周之前出生的新生儿出生体重P 50略高于Fenton2013参照值13~81 g，之后逐渐低于Fenton2013，41~42周差值达148~367 g；Fenton2013出生体重的P 10曲线在出生胎龄40周前男女均低于本研究11~64 g。
结论新建立了中国出生胎龄24~42周男、女新生儿出生体重、身长和头围的生长参照标准，供新生儿出生时及早产儿生后早期的生长和营养评价，建议将出生体重低于本参照标准P 10作为小于胎龄儿（SGA）界值点，将低于P 3作为重度SGA界值点。
ObjectiveTo study and formulate the growth standards for birth weight, length and head circumference of Chinese newborns of different gestation.
MethodsA cross-sectional survey was carried out by the stratified cluster sampling method from June 2015 to November 2018 in 13 cities including Beijing, Harbin, Xi′an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou, Kunming, Tianjin, Shenyang, Changsha and Shenzhen. A total of 24 375 newborns with gestational age between 24 to 42 weeks were included. The standard percentile-curves of birth weight, length and head circumference for newborn boys and girls in gestational weeks 24 to 42 were established by the generalized additive model for location, scale and shape (GAMLSS). The new reference standard developed in this study was compared with the reference values of China in 1988 and the international Fenton 2013.
ResultsAmong the 24 375 newborns (13 197 males (54.1%),11 178 females (45.9%)), 12 264 were preterm infants and 12 111 were full term infants. The 3 rd, 10 th, 25 th, 50 th, 75 th, 90 th and 97 th percentile reference values and curves of birth weight, length and head circumference were obtained for male and female newborns from 24 to 42 gestation weeks. The data showed that birth weight, length and head circumference increased rapidly with the gestational age, but the growth velocity decreased slightly from 37 weeks. For example, the median birth weight for males at 28 weeks, 32 weeks, 37 weeks and 40 weeks was 1 154, 1 805, 2 943 and 3 455 g, respectively. The birth weight, length and head circumference of males at all gestational ages were 87-133 g, 0.2-0.9 cm and 0.3-0.6 cm higher than those of females, respectively. Compared with the percentile curves of birth weight of Chinese reference in 1988, there were significant differences regarding the percentile lines of males and females, especially the 10 th, 50 th, and 90 th percentile values of birth weight were significantly higher than the reference values in 1988 from 37 to 42 gestation weeks. For example, the median birth weight at 40 weeks in the study was 115-242 g higher than that in 1988. Compared with the standard reference of Fenton 2013, the reference curve at 50 th percentile of birth weight in this study was 13-81 g slightly higher than that of Fenton 2013 before 33 weeks, and then it was gradually lower than that of Fenton 2013 and the difference was 148-367 g at 41 to 42 weeks of gestation. The 10 th percentile curve of Fenton 2013 was 11-64 g lower than that of this study in both males and females before 40 weeks.
ConclusionsThis study created a new national growth standard of birth weight, body length and head circumference for Chinese neonates at 24 to 42 weeks of gestation, which can be used for the growth and nutrition evaluation of newborns at birth and preterm infants in the early postnatal period. The 10 th percentile and the 3 rd percentile of growth standards could be suggested as the cut-off point for identifying small for gestational age and severe small for gestational age, respectively.
首都儿科研究所,九市儿童体格发育调查协作组. 中国不同出生胎龄新生儿出生体重、身长和头围的生长参照标准及曲线[J]. 中华儿科杂志,2020,58(09)：738-746.
DOI:10.3760/cma.j.cn112140-20200316-00242版权归中华医学会所有。
未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。
除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。
文档即答
智问智答
机器翻译
你好，我可以帮助您更好的了解本文，请向我提问您关注的问题。
