Child growth

儿童成长
  • 文章类型: Journal Article
    生命的前1000天对儿童的健康和发展至关重要。这一时期的生长障碍与儿童发病率增加有关,死亡率,和长期后果。营养不良是主要原因,在生命的前1000天内解决这个问题至关重要。产妇教育一直被认为是儿童营养不良的重要预测因素,但其具体影响尚待确定。这项研究提供了系统的回顾和荟萃分析,调查了高与低母亲教育水平对从出生到两岁儿童成长的影响,使用基于人群的队列研究。
    包括PubMed、Scopus,EMBASE,WebofScience,ERIC,和GoogleScholar从1990年1月到2024年1月使用适当的搜索词进行搜索。我们纳入了以人群为基础的2岁及以下健康儿童及其母亲的队列研究,对产妇教育水平进行分类。使用各种指标评估儿童生长和营养结果。两名评审员独立进行数据提取并评估研究质量。纽卡斯尔渥太华量表用于质量评估。随机效应模型用于荟萃分析,异质性使用CochraneQ和I2统计量进行评估。进行亚组和敏感性分析,并评估发表偏倚。
    文献检索到14295种,在对639份报告进行全文筛选后,包括35项研究,涵盖八个结果:体重年龄z得分(WAZ),身高年龄z评分(HAZ),BMI为年龄z得分(BMIZ),超重,体重不足,发育迟缓,浪费,和快速的体重增加。在中等收入国家,母亲受教育程度较高与儿童WAZ(MD0.398,95%CI0.301-0.496)和HAZ(MD0.388,95%CI0.102-0.673)升高显著相关.同样,在对低教育人口的研究中,较高的产妇教育水平与WAZ(MD0.186,95%CI0.078-0.294)和HAZ(0.200,95%CI0.036-0.365)的增加显著相关.然而,在高收入和受过高等教育的人群中,这种联系要么不存在,要么逆转。在高收入国家,母亲受教育程度较高与BMI-Z无显著降低相关(MD-0.028,95%CI-0.061~0.006).值得注意的是,这种负相关在低教育人群中具有统计学意义(MD-0.045,95%CI-0.079~-0.011),但在高教育人群中没有统计学意义(MD0.003,95%CI-0.093~0.098).
    产妇教育与儿童成长的关系因国家/地区的收入和教育水平而异。需要进一步研究才能更好地理解这种关系。
    这项研究是由德黑兰医科大学(TUMS)资助的学生论文。
    UNASSIGNED: The first 1000 days of life are critical for a child\'s health and development. Impaired growth during this period is linked to increased child morbidity, mortality, and long-term consequences. Undernutrition is the main cause, and addressing it within the first 1000 days of life is vital. Maternal education is consistently identified as a significant predictor of child undernutrition, but its specific impact remains to be determined. This study presents a systematic review and meta-analysis investigating the influence of high versus low maternal education levels on child growth from birth to age two, using population-based cohort studies.
    UNASSIGNED: Databases including PubMed, Scopus, EMBASE, Web of Science, ERIC, and Google Scholar were searched from January 1990 to January 2024 using appropriate search terms. We included population-based cohort studies of healthy children aged two years and under and their mothers, categorizing maternal education levels. Child growth and nutritional outcomes were assessed using various indicators. Two reviewers independently conducted data extraction and assessed study quality. The Newcastle Ottawa scale was utilized for quality assessment. Random-effects models were used for meta-analysis, and heterogeneity was assessed using the Cochrane Q and I2 statistic. Subgroup and sensitivity analyses were performed, and publication bias was evaluated.
    UNASSIGNED: The literature search retrieved 14,295 titles, and after full-text screening of 639 reports, 35 studies were included, covering eight outcomes: weight for age z-score (WAZ), height for age z-score (HAZ), BMI for age z-scores (BMIZ), overweight, underweight, stunting, wasting, and rapid weight gain. In middle-income countries, higher maternal education is significantly associated with elevated WAZ (MD 0.398, 95% CI 0.301-0.496) and HAZ (MD 0.388, 95% CI 0.102-0.673) in children. Similarly, in studies with low-educated population, higher maternal education is significantly linked to increased WAZ (MD 0.186, 95% CI 0.078-0.294) and HAZ (0.200, 95% CI 0.036-0.365). However, in high-income and highly educated population, this association is either absent or reversed. In high-income countries, higher maternal education is associated with a non-significant lower BMI-Z (MD -0.028, 95% CI -0.061 to 0.006). Notably, this inverse association is statistically significant in low-educated populations (MD -0.045, 95% CI -0.079 to -0.011) but not in highly educated populations (MD 0.003, 95% CI -0.093 to 0.098).
    UNASSIGNED: Maternal education\'s association with child growth varies based on country income and education levels. Further research is needed to understand this relationship better.
    UNASSIGNED: This study was a student thesis supported financially by Tehran University of Medical Sciences (TUMS).
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  • 文章类型: Journal Article
    已经提出了儿童期心理社会压力源,以支持快速生活史策略,以促进女性的青春期提前。然而,证明这种关联的研究通常不能阐明因果机制,也不能解释儿童时期更多的精力供应-也可以促进快速生长和更早的青春期。为了评估这种混杂因素被认为的程度,我们进行了系统化的审查,以确定检查两种青春期前生长指标的研究(例如体重,身高)和心理社会压力源(例如逆境,父亲缺席)与女性青春期时间的关系。在五个数据库中确定了总共1069项非重复研究。20项研究符合独立筛选标题后批判性审查的选择标准,摘要和手稿。在这些研究中,与心理社会压力的指标相比,表明儿童快速成长的指标与青春期早期更一致。我们讨论了未来的研究方向,以更有力地研究社会心理压力对青春期时间的影响,包括方法论和机械方面的考虑,和社会生态环境对研究结果的语境化。
    Childhood psychosocial stressors have been proposed to favour fast life history strategies promoting earlier puberty in females. However, studies demonstrating this association often do not elucidate causal mechanisms, nor account for greater childhood energetic availability - also known to promote rapid growth and earlier puberty. To assess the extent to which such confounding has been considered, we conducted a systematized review to identify studies examining measures of both prepubertal growth (e.g. weight, height) and psychosocial stressors (e.g. adversity, father absence) in relation to female pubertal timing. A total of 1069 non-duplicated studies were identified across five databases. Twenty studies met selection criteria for critical review following independent screening of titles, abstracts and manuscripts. Within these studies, measures indicative of rapid childhood growth were more consistently associated with earlier pubertal timing than were measures of psychosocial stress. We discuss future research directions to investigate the impact of psychosocial stress on pubertal timing more robustly, including methodological and mechanistic considerations, and contextualization of findings by socioecological environments.
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  • 文章类型: Journal Article
    我们研究了包括非父母照顾者参与儿童肥胖预防干预措施在内的文献范围。
    我们按照Arksey和O\'Malley框架进行了范围审查,包括仅报告干预对生长影响的研究,体重,或0至3岁儿童的早期儿童肥胖风险,2000年至2021年出版。不包括非父母照顾者(除父母外经常参与儿童保育的成年人)的干预措施被排除在外。
    在符合纳入标准的14项研究中,所有干预措施均在2013年至2020年期间发表,大多数干预措施(n=9)在美国实施.14项干预措施中有8项有意包括其他非父母照顾者:5项包括父母和非父母照顾者,其余三人只包括非父母照顾者。大多数干预措施(n=9)对人体测量结果没有显着影响。所有干预措施都发现至少一种行为结果有所改善(例如,食物组摄入量(n=5),父母喂养方式(n=3),和屏幕时间(n=2))。这项审查可以告知未来计划让非父母照顾者参与的干预措施,这可能有利于塑造早期健康行为和预防生命早期肥胖。
    We examined the scope of literature including non-parental caregiver involvement in child obesity prevention interventions.
    We conducted a scoping review following the Arksey and O\'Malley framework, including only studies reporting the effect of an intervention on growth, weight, or early childhood obesity risk among children ages 0 to three years, published between 2000 and 2021. Interventions that did not include non-parental caregivers (adults regularly involved in childcare other than parents) were excluded.
    Of the 14 studies that met the inclusion criteria, all were published between 2013 and 2020, and most interventions (n = 9) were implemented in the United States. Eight of the 14 interventions purposefully included other non-parental caregivers: five included both parents and non-parental caregivers, and the remaining three included only non-parental caregivers. Most interventions (n = 9) showed no significant impact on anthropometric outcomes. All interventions found improvements in at least one behavioral outcome (e.g., food groups intake (n = 5), parental feeding practices (n = 3), and screen time (n = 2)). This review can inform future interventions that plan to involve non-parental caregivers, which may be beneficial in shaping early health behaviors and preventing obesity early in life.
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  • 文章类型: Journal Article
    2014年,紧急营养网络发布了一份关于消瘦和发育迟缓之间关系的报告。我们旨在审查自审查以来产生的证据,以更好地了解改善儿童营养的含义,健康和生存。我们遵循PRISMA指南进行了系统审查,在PROSPERO注册。我们确定了描述浪费和发育迟缓的搜索词以及两者之间的关系。我们纳入了低收入和中等收入国家五岁以下儿童的研究,这些研究评估了体重增长/消瘦和线性增长/发育迟缓以及两者之间的关联。我们纳入了45项研究。审查发现,消瘦和发育迟缓的高峰发生率在出生至3个月之间。这两种情况之间有很强的联系,消瘦的发作会导致发育迟缓,在较小程度上,发育迟缓会导致浪费。有多个人体测量缺陷的儿童,包括同时发育迟缓和消瘦,与仅有任何一种缺陷的儿童相比,近期死亡的风险最高。此外,有证据表明,使用中上臂围结合年龄体重Z评分可有效确定近期死亡风险最高的儿童.浪费和发育迟缓,在共同因素的驱动下,经常发生在同一个孩子身上,在他们的生命历程中,同时或在不同的时刻。有证据表明,儿童一生中营养缺乏积累和死亡风险增加的过程表明,迫切需要采取综合政策,预防和治疗儿童营养不良的筹资和方案方法。
    In 2014, the Emergency Nutrition Network published a report on the relationship between wasting and stunting. We aim to review evidence generated since that review to better understand the implications for improving child nutrition, health and survival. We conducted a systematic review following PRISMA guidelines, registered with PROSPERO. We identified search terms that describe wasting and stunting and the relationship between the two. We included studies related to children under five from low- and middle-income countries that assessed both ponderal growth/wasting and linear growth/stunting and the association between the two. We included 45 studies. The review found the peak incidence of both wasting and stunting is between birth and 3 months. There is a strong association between the two conditions whereby episodes of wasting contribute to stunting and, to a lesser extent, stunting leads to wasting. Children with multiple anthropometric deficits, including concurrent stunting and wasting, have the highest risk of near-term mortality when compared with children with any one deficit alone. Furthermore, evidence suggests that the use of mid-upper-arm circumference combined with weight-for-age Z score might effectively identify children at most risk of near-term mortality. Wasting and stunting, driven by common factors, frequently occur in the same child, either simultaneously or at different moments through their life course. Evidence of a process of accumulation of nutritional deficits and increased risk of mortality over a child\'s life demonstrates the pressing need for integrated policy, financing and programmatic approaches to the prevention and treatment of child malnutrition.
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  • 文章类型: Journal Article
    世界卫生组织(WHO)的成长标准提供了最公认和广泛接受的评估儿童成长的方法。为了确保其适用性,准确度,和可靠性,研究已针对当地人群和其他国际公认的增长参考验证了世卫组织的增长标准。我们回顾了对世卫组织生长标准进行评估的结果,并评估了在全球范围内使用这些生长标准的适当性。我们从多个数据库中对2011年至2020年发表的研究进行了系统的定量审查。如果他们考虑了59个月及以下的儿童并报告了生长标准的验证,则纳入研究。在研究中达成了一项协议,验证了世卫组织的生长标准与国际生长参考,表明其在识别发育不良方面的优越性,超重,和肥胖儿童。然而,他们不太可能识别体重不足的儿童。审查的研究都没有报告在所有考虑的指标中与世卫组织标准相似的生长轨迹。与WHO生长标准相比,观察到儿童生长的区域差异。采用区域特定标准可提高识别营养不良儿童的敏感性。
    The World Health Organization (WHO) growth standards provide the most recognized and widely accepted way of assessing child growth. To ensure its applicability, accuracy, and reliability, studies have validated WHO growth standards against local populations and other internationally recognized growth references. We reviewed outcomes of evaluations done on WHO growth standards and assess the appropriateness of using these growth standards on a global level. We undertook a systematic quantitative review of studies published from 2011 to 2020 from multiple databases. Studies were included if they considered children aged 59 months and below and reported on validation of growth standards. There was an agreement in studies that validated WHO growth standards against international growth references of its superiority in identifying stunted, overweight, and obese children. However, they were less likely to identify underweight children. None of the studies reviewed reported similar growth trajectories to WHO standards in all indicators considered. Regional differences in child growth were observed in comparison to WHO growth standards. Adoption of regional-specific standards increases the sensitivity of identifying children with adverse nutrition outcomes.
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  • 文章类型: Journal Article
    黄曲霉毒素是真菌毒素,具有急性威胁生命的毒性,致癌特性和其他潜在的慢性不良影响。饮食中接触黄曲霉毒素被认为是一个主要的公共卫生问题,特别是撒哈拉以南非洲和南亚的自给农业社区,由于气候炎热潮湿和储存不良,花生和玉米等膳食主食作物往往受到黄曲霉毒素的高度污染,再加上风险意识低和缺乏监管限制的执行。已经开发了生物标志物,并将其应用于许多流行病学研究中,以评估这些高危人群中黄曲霉毒素的暴露及其相关的健康影响。这篇综述讨论了黄曲霉毒素暴露的最新流行病学证据,与其他霉菌毒素的共同暴露和相关的健康影响,以提供风险评估的证据,并强调需要进一步研究的领域。黄曲霉毒素暴露可发生在生命的任何阶段,是肝细胞癌的主要危险因素,特别是当乙型肝炎感染存在时。最近的证据表明,黄曲霉毒素可能是儿童发育迟缓的潜在决定因素,并可能降低细胞介导的免疫力,从而增加疾病易感性。然而,黄曲霉毒素暴露与后一种不良健康结果之间的因果关系尚未确定,这些的生物学机制尚未阐明,促使进一步研究。此外,关于黄曲霉毒素与其他霉菌毒素共同接触对健康的影响的信息缺乏。生物标志物的最新发展为该领域的重要未来研究提供了机会。
    Aflatoxins are fungal toxins that possess acute life threatening toxicity, carcinogenic properties and other potential chronic adverse effects. Dietary exposure to aflatoxins is considered a major public health concern, especially for subsistence farming communities in sub-Saharan Africa and South Asia, where dietary staple food crops such as groundnuts and maize are often highly contaminated with aflatoxin due to hot and humid climates and poor storage, together with low awareness of risk and lack of enforcement of regulatory limits. Biomarkers have been developed and applied in many epidemiological studies assessing aflatoxin exposure and the associated health effects in these high-risk population groups. This review discusses the recent epidemiological evidence for aflatoxin exposure, co-exposure with other mycotoxins and associated health effects in order to provide evidence on risk assessment, and highlight areas where further research is necessary. Aflatoxin exposure can occur at any stage of life and is a major risk factor for hepatocellular carcinoma, especially when hepatitis B infection is present. Recent evidence suggests that aflatoxin may be an underlying determinant of stunted child growth, and may lower cell-mediated immunity, thereby increasing disease susceptibility. However, a causal relationship between aflatoxin exposure and these latter adverse health outcomes has not been established, and the biological mechanisms for these have not been elucidated, prompting further research. Furthermore, there is a dearth of information regarding the health effects of co-exposure to aflatoxin with other mycotoxins. Recent developments of biomarkers provide opportunities for important future research in this area.
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  • 文章类型: Journal Article
    The aim of this study was to systematically review associations between dietary mycotoxins exposure and child growth and morbidity of children aged 5 years or younger. Peer-reviewed literature was searched in MEDLINE, EMBASE, COCHRANE, CINAHL, Web of Science, and PsycINFO. Experimental and observational studies were considered. The exposures were dietary mycotoxins during pregnancy, lactation and childhood, and mycotoxins concentrations in the diet, breast milk, urine, and blood. From a total of 4869 references, 86 full-text papers were extracted of which 50 were included in this review. The methodological quality and risk of bias were evaluated and quality of the collective evidence was assessed using GRADE. Uncertainty remains whether mycotoxins exposure affects child growth, immunity and mortality and the overall quality of the evidence is very low. Overall however, we cannot rule out a possible association between dietary mycotoxins, in particular, AF and FUM and child malnutrition. Our analyses were limited by the reporting quality, difference in findings, heterogeneity of outcomes, mycotoxins detection methods, and the observational nature of most studies. Robust study designs with adequate sample size, use of validated biomarkers of exposure and assessment of co-occurrence of mycotoxins and their synergistic effects are required to provide the further evidence regarding a potential effect of dietary mycotoxins exposure on child growth and immunity.
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  • 文章类型: Journal Article
    BACKGROUND: Despite considerable global efforts to reduce growth faltering in early childhood, rates of stunting remain high in many regions of the world. Current interventions primarily target nutrition-specific risk factors, but these have proven insufficient. The objective of this study was to synthesize the evidence on the relationship between active tobacco use during pregnancy and growth outcomes in children under five years of age.
    METHODS: In this systematic review and meta-analysis, six online databases were searched to identify studies published from January 1, 1980, through October 31, 2016, examining the association between active tobacco use during pregnancy and small-for-gestational age (SGA), length/height, and/or head circumference. Ecological studies were not included. A meta-analysis was conducted, and subgroup analyses were carried out to explore the effect of tobacco dosage.
    RESULTS: Among 13,189 studies identified, 210 were eligible for inclusion in the systematic review, and 124 in the meta-analysis. Active tobacco use during pregnancy was associated with significantly higher rates of SGA (pooled adjusted odds ratio [AORs] = 1.95; 95% confidence interval [CI]: 1.76, 2.16), shorter length (pooled weighted mean difference [WMD] = 0.43; 95% CI: 0.41, 0.44), and smaller head circumference (pooled WMD = 0.27; 95% CI: 0.25, 0.29) at birth. In addition, a dose-response effect was evident for all growth outcomes.
    CONCLUSIONS: Tobacco use during pregnancy may represent a major preventable cause of impaired child growth and development.
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  • 文章类型: Journal Article
    OBJECTIVE: To evaluate the effects of depressive symptom management interventions (DSMI) for low-income mothers.
    BACKGROUND: Depressive symptoms and depression are common complications following childbirth. Depressive symptoms experienced by low-income mothers negatively affect infant-toddler development.
    METHODS: A systematic review and meta-analysis was conducted to provide a synthesized and critical appraisal of the included studies.
    METHODS: We conducted a systematic search of randomized controlled trials in the following electronic databases through November 2017: PubMed, EMBASE, CINAHL, PsycInfo, and Cochrane Library CENTRAL.
    METHODS: Ten studies were found in the systematic review of DSMI in terms of content, mode of delivery, session, and provider. We then conducted a meta-analysis of nine randomized controlled trials with 798 participants, comparing low-income mothers with and without DSMI.
    RESULTS: A significant effect was noted for DSMI in improving depressive symptoms in low-income mothers with young children and for interventions lasting 8 weeks or less.
    CONCLUSIONS: The meta-analysis suggested that DSMI for low-income mothers can be effective; however, the effectiveness varies by intervention type, intervention duration, and whether the mothers had other children.
    CONCLUSIONS: The findings of this study will contribute to the development of effective DSMI by providing scientific evidence for the development of such programmes for low-income mothers, especially with respect to target population and intervention duration.
    目的: 评价抑郁症状管理介入(DSMI)对低收入母亲的影响。 背景: 抑郁症状和抑郁症是分娩后常见的并发症。低收入母亲的抑郁症状会对婴幼儿的成长产生负面影响。 设计: 通过系统综述和荟萃分析对纳入研究进行了综合、严格的评价。 资料来源: 截至2017年11月,我们对以下电子数据库中的随机对照试验进行了系统搜索:PubMed、EMBASE、CINAHL、PsycInfo和Cochrane Library CENTRAL。 综述方法: 在对DSMI的系统综述中发现了十项研究,涉及内容、分娩方式、会议和供养人。然后,我们对有798名参与者的九项随机对照试验进行了荟萃分析,比较了有和没有进行抑郁症状管理介入的低收入母亲。 结果: 干预措施持续8周或更短时间的抑郁症状管理介入能显著改善幼儿低收入母亲的抑郁症状。 结论: 荟萃分析表明,抑郁症状管理介入对低收入母亲有效;然而,该影响因介入类型、介入持续时间和母亲是否有其他孩子而异。 影响: 这项研究的结果将有助于发展有效的抑郁症状管理介入,为低收入母亲制定此类方案提供科学证据,特别是在目标人群和干预持续时间方面。.
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  • 文章类型: Historical Article
    To scrutinize to what extent modern ideas about nutrition effects on growth are supported by historic observations in European populations.
    We reviewed 19th and early 20th century paediatric journals in the Staatsbibliothek zu Berlin, the third largest European library with an almost complete collection of the German medical literature. During a three-day visit, we inspected 15 bookshelf meters of literature not available in electronic format.
    Late 19th and early 20th century breastfed European infants and children, independent of social strata, grew far below World Health Organisation (WHO) standards and 15-30% of adequately-fed children would be classified as stunted by the WHO standards. Historic sources indicate that growth in height is largely independent of the extent and nature of the diet. Height catch-up after starvation was greater than catch-up reported in modern nutrition intervention studies, and allowed for unimpaired adult height.
    Historical studies are indispensable to understand why stunting does not equate with undernutrition and why modern diet interventions frequently fail to prevent stunting. Appropriateness and effect size of modern nutrition interventions on growth need revision.
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