Impact of the COVID-19 infection on children with allergic diseases in China.

BACKGROUND: The COVID-19 pandemic has prompted investigations into the association between this novel virus and allergic diseases, particularly asthma in children. However, the nature of this relationship remains poorly established. OBJECTIVE: This study aims to determine the clinical characteristics of children with allergic diseases who have contracted COVID-19. METHODS: A retrospective study was conducted at the Children's Hospital Affiliated to the Capital Institute of Pediatrics from January to March 2023. A total of 568 children aged 0-17 years diagnosed with asthma and COVID-19 infection were included. A comparative analysis of clinical characteristics was conducted between asthma and non-asthma groups. RESULTS: Asthmatic children with COVID-19 infection showed significantly higher frequencies of cough, wheezing, expectoration, and long-term symptoms compared to those without asthma (P < 0.05). Subgroups with poor therapy compliance exhibited elevated proportions of cough, chest tightness, and wheezing compared to good therapy compliance (P < 0.05). Multivariate logistic regression identified poor therapy compliance as a risk factor for long COVID in asthmatic children. CONCLUSION: Children with asthma secondary to COVID-19 infection were more prone to developing coughs, expectoration, and wheezing. Poor therapy compliance emerged as a significant risk factor for long COVID-19 in these individuals. IMPACT: Asthmatic children with COVID-19 infection showed significantly higher frequencies of cough, wheezing, expectoration. Poor therapy compliance was the risk factor for long COVID in asthmatic children. This article supplements the effects of different therapeutic drugs on the condition of children with asthma after infection with COVID-19 as well as the possible risk factors for the long COVID. The results of our study have important implications for public health policy makers and healthcare professionals. To understand the impact of COVID-19 on children with asthma will help guide appropriate management strategies and ensure access to necessary healthcare resources.

The quality of life in Chinese juvenile idiopathic arthritis patients: psychometric properties of the pediatric quality of life inventor generic core scales and rheumatology module.

BACKGROUND: Juvenile idiopathic arthritis (JIA) may seriously affects patients' quality of life (QoL), but it was rarely focused and studied in China, so we explore JIA children's QoL using Chinese version of the PedsQL4.0 Generic Core and PedsQL3.0 Rheumatology Module scale, and analyzed the psychometric properties of these two Scales among Chinese JIA children. METHODS: We recruited 180 JIA patients from Children's Hospital Affiliated to Capital Institute of Pediatrics and Hebei Yanda Hospital from July 2018 to August 2019. The questionnaires include information related on JIA, PedsQL4.0 generic core and PedsQL3.0 Rheumatology Module scales. According to the disease type, onset age of and course of JIA, we divided them into different groups, then compared the QoL status among different groups. Moreover, we analyzed the reliability and validity of these two scales in these 180 JIA children. RESULTS: The mean score of PedsQL4.0 generic core scale on these 180 patients was 82.85 ± 14.82, for these in active period was 72.05 ± 15.29, in remission period was 89.77 ± 9.23; the QoL score of systemic, polyarticular and oligoarticular JIA patients were 77.05 ± 19.11, 84.33 ± 12.46 and 87.12 ± 10.23. The mean score of PedsQL3.0 Rheumatology Module scale on 180 patients was 91.22 ± 9.45, for these in active period was 84.70 ± 11.37, in remission period was 95.43 ± 4.48; the QoL score of systemic, polyarticular and oligoarticular JIA patients were 89.41 ± 11.54, 89.38 ± 10.08 and 93.71 ± 6.92. In the PedsQL 4.0 Generic Core scale, the α coefficients of total scale and almost every dimension are all greater than 0.8 except for the school activity dimension of 0.589; the correlation coefficients of 22 items' scores (total 23 items) with the scores of dimensions they belong to are greater than 0.5 (maximum value is 0.864), and the other one is 0.406. In PedsQL3.0 Rheumatology Module scale, except for the treatment and worry dimensions of 0.652 and 0.635, the α coefficients of other dimensions and the total scale are all greater than 0.7; the correlation coefficients of all items' score were greater than 0.5 (the maximum is 0.933, the minimum is 0.515). CONCLUSIONS: The QoL of Chinese JIA children is worse than their healthy peers, these in active period and diagnosed as systemic type were undergoing worst quality of life. The reliability and validity of PedsQL 4.0 Generic Core and PedsQL3.0 Rheumatology Module scale in Chinese JIA children are satisfactory, and can be used in clinical and scientific researches.

Child nutrition to new stage in China: evidence from a series of national surveys, 1985-2015.

BACKGROUND: Both child under- and over-nutrition are major global public health challenges. We aimed to examine thirty-year trends in physical growth, under- and over-nutrition in Chinese urban and suburban children between 1985 and 2015, and discuss implications for child health programmes. METHODS: A total of 610,785 urban and suburban children from birth to 7 years of age were collected from a series of large-scale national surveys in China. Height, weight and body mass index (BMI) Z-scores and prevalence of stunting, underweight, wasted and possible risk of overweight, overweight and obesity were calculated according to the World Health Organization (WHO) 2006 growth standards. The trends in the prevalence were tested across different survey years by Cochran-Armitage trend test. RESULTS: Rapid secular growth trend was observed in China over the past 30 years, but the trend showed a slowing sign in urban children in recent 10 years. The growth level of Chinese urban and suburban children surpassed the WHO 2006 growth standards in 2015. Between 1985 and 2015 the stunting, underweight and wasted prevalence decreased from 12.21, 4.44, 1.68 to 0.97%, 0.59, 0.87% for children under 5 years and from 12.69, 10.02, 3.41 to 0.42%, 0.67, 2.17% for children aged 5- < 7 respectively; the possible risk of overweight prevalence increased from 6.51 to 12.57%, overweight from 0.70 to 3.48% and obesity from 0.17 to 0.86% for children aged 2- < 7 and the increasing rates of overweight and obesity prevalence in suburban children first outnumbered urban children in recent 10 years. The overweight prevalence overtook the wasted or underweight in children aged 2- < 7 in 2005 and onward. CONCLUSION: Slowing secular height trend and overweight prevalence overtaking the wasted or underweight suggested child nutrition and health strategies should adjust swiftly and deliberately from primarily reducing under-nutrition prevalence to controlling rapid weight gain and promoting integrated early development.

National survey showed that Chinese city children under two years of age had similar feeding patterns to developed countries.

AIM: This 2015 study was a part of the National Growth Survey of Children under seven years of age, which has been carried out in nine Chinese cities every 10 years since 1975. Our aim was to assess children's feeding practices and nutritional supplements. METHODS: This was a cross-sectional survey of 89 006 healthy children aged one to 24 months. All data were collected by face-to-face interviews during child health visits, using a questionnaire. RESULTS: The exclusive breastfeeding rate was 53% in infants under six months of age, and the continued breastfeeding rate was 51% among infants who were 10-12 months and 5% when they were 21-24 months. Infants were weaned at a mean of 9.3 months in urban areas and 9.4 months in suburban areas. Cereals were provided as complementary food at a mean age of five months, eggs at six months, meat at eight and a half months and bean products at over 12 months. The most common nutritional supplements given to the children were vitamins A and D and calcium. CONCLUSION: The feeding practices of Chinese city children were similar to those in developed countries, but strategies are needed to promote more rational consumption of nutritional supplements.

Waist circumference and waist-to-height ratio in Chinese pre-school children: results from the 5th National Survey in 2015.

BACKGROUND: Waist circumference (WC) and waist-to-height ratio (WHtR) distributions have been described in Chinese pre-school children only in local areas. AIM: To report reference data of WC and WHtR in a nationally representative sample of Chinese pre-school children. SUBJECTS AND METHODS: A total of 53,172 children aged 3-7 years were surveyed as part of the 5th National Survey in 2015. WC and WHtR percentile values were calculated for each age- and sex-specific group. Urban-suburban rural differences of WC and WHtR were examined. Comparisons of WC and WHtR with other Chinese studies and foreign studies were assessed. RESULTS: Eleven conventional percentile values of WC and WHtR were obtained for urban and suburban rural children. Urban-suburban rural differences of WC ranged from -0.2 cm to 0.6 cm for both boys and girls across all age groups and the differences of WHtR ranged from -0.01 to 0.01. Median WC and WHtR curves were generally in the middle of other Chinese studies. Median WC and WHtR curves in China were generally lower than other countries that were compared. CONCLUSION: The presented percentile values of WC and WHtR may be useful to monitor growth and development and to assess abdominal fat distribution of younger children.

The 5th national survey on the physical growth and development of children in the nine cities of China: Anthropometric measurements of Chinese children under 7 years in 2015.

OBJECTIVES: To describe the physical growth of healthy children under 7 years in China based on the latest national survey and provide more data for revising growth reference and monitoring the impact of social development on children's health and growth. METHODS: In the cross-sectional survey, 161,774 healthy children under 7 years were selected by multistage stratified cluster sampling method in nine cities of China. According to the geographical location, the nine cities were divided into northern, central and southern regions, and each city included urban and suburban areas. Anthropometric measurements were obtained on the spots and other related information was collected with questionnaires. RESULTS: There were slight urban-suburban difference and obvious regional difference in anthropometric measurements in China. Comparison with the 4th NSPGDC in 2005, measurements increased 0.1-1.1 kg in weight, 0.5-1.8 cm in height in urban areas (except children under 3 years) and 0.1-2.5 kg in weight, 0.2-3.8 cm in height in suburban areas. The urban-suburban difference of those measurements became smaller than 10 years ago, but their regional difference persistently exist. Chinese children were 0.36 SD in weight, 0.43 SD in height in urban areas and 0.30 SD in weight, 0.30 SD in height in suburban areas higher than WHO standards. CONCLUSIONS: Physical growth of children under 7 years old was undergoing a slowly positive secular trend during the latest decade in more economically developed regions of China. Urban-suburban difference of those measurements became smaller, while their regional difference persistently exist. Chinese healthy children under 7 years in nine cities was taller and heavier than WHO standards.

Narrowing urban-suburban rural disparities in physical growth among children in China: findings from the 5th national survey in 2015.

BACKGROUND: Previous studies have reported a narrowing tendency in urban-suburban rural differences for height, but almost no tendency of narrowing for weight in Chinese children between 1975-2005. AIM: To examine urban-suburban rural disparities for both height and weight in a recent 10-year period. SUBJECTS AND METHODS: A representative sample of 161,643 children under 7 years old was obtained from the 5th national survey conducted in urban and suburban rural areas of the nine cities in China in 2015. Trends in urban-suburban rural differences were assessed from 1975-2015. RESULTS: Generally, urban boys and girls were taller or heavier than their suburban rural counterparts. By 2015, there were almost no obvious differences for urban-suburban rural height differences for children under 3. Urban-suburban rural weight differences narrowed sharply in the 10-year period. There were no obvious differences for urban-suburban rural height differences among the 3rd, 50th and 97th percentiles; however, the weight differences at the 97th percentile were larger than at the 50th percentile for children over 3. CONCLUSION: The narrowing urban-suburban rural disparities in China suggest the physical growth inequality may be eliminated, along with the sustained improvement of socioeconomic status and the acceleration of urbanisation process in suburban rural areas.

Weight-for-length/height growth curves for children and adolescents in China in comparison with body mass index in prevalence estimates of malnutrition.

BACKGROUND: It is important to update weight-for-length/height growth curves in China and re-examine their performance in screening malnutrition. AIM: To develop weight-for-length/height growth curves for Chinese children and adolescents. SUBJECTS AND METHODS: A total of 94 302 children aged 0-19 years with complete sex, age, weight and length/height data were obtained from two cross-sectional large-scaled national surveys in China. Weight-for-length/height growth curves were constructed using the LMS method before and after average spermarcheal/menarcheal ages, respectively. Screening performance in prevalence estimates of wasting, overweight and obesity was compared between weight-for-height and body mass index (BMI) criteria based on a test population of 21 416 children aged 3-18. RESULTS: The smoothed weight-for-length percentiles and Z-scores growth curves with length 46-110 cm for both sexes and weight-for-height with height 70-180 cm for boys and 70-170 cm for girls were established. The weight-for-height and BMI-for-age had strong correlation in screening wasting, overweight and obesity in each age-sex group. There was no striking difference in prevalence estimates of wasting, overweight and obesity between two indicators except for obesity prevalence at ages 6-11. CONCLUSION: This set of smoothed weight-for-length/height growth curves may be useful in assessing nutritional status from infants to post-pubertal adolescents.

The prevalence of overweight, obesity and stunting in school children aged 6-19 years in Beijing, China.

BACKGROUND: Childhood/adolescent obesity and stunting are associated with heightened risk of metabolic syndrome. Understanding the prevalence and patterns of stunting, the emergence of overweight/obesity in children and adolescents and the concomitant risk for metabolic syndrome is of critical importance for public health policy. AIM: To investigate the prevalence of overweight, obesity and stunting in school children and adolescents aged 6-19 years in Beijing and to compare the differences in screening rates by national and international references. SUBJECTS AND METHODS: School children aged 6-19 years in Xuanwu, Haidian and Fangshan district were selected. Overweight and obesity in the children was screened for using the International Obesity Task-force (IOTF) and Chinese standards. Stunting was defined as height-for-age Z-score (HAZ) less than -2 using the 2009 Chinese standards and 2007 WHO reference. RESULTS: A total of 99 482 children were included in this survey. The prevalences of overweight and obesity are 17.7% and 14.4% in the Chinese standard, but they are 18.1% and 8.6% in the IOTF standard; there were significant differences between the prevalences of these two standards (p < 0.01). The prevalences of overweight/obesity in boys are all significantly higher than that of girls in every age-group (p < 0.05). Overall there was stunting in 2630 children and adolescents (2.6%) according to the Chinese standards, with 2.8% in boys, higher than the 2.5% of girls (p < 0.01). According to WHO standards, there was stunting in 1201 children and adolescents (1.2%) with 1.1% in boys and 1.3% in girls (p < 0.05). The prevalence of stunting in urban areas was 1.3%, which is significantly lower than that of suburban areas, at 3.9% (p < 0.01). CONCLUSION: The prevalence of overweight/obesity in children and adolescents aged 6-19 years in Beijing was close to western countries, which should be highly valued when considering public health policies and the problem of growth stunting should not be ignored.

Three Therapy Regimens and Their Cost-effectiveness for Girls With Central Precocious Puberty: A Real-World Clinical Study.

The objective of this study was to evaluate the effectiveness and cost-effectiveness of different therapy regimens for girls with central precocious puberty (CPP). This study retrospectively analyzed CPP girls from 2013 to 2021 and grouped them into GnRHa, Mixed, and GnRHa+GH based on therapy regimen. While comparing the differences among these groups, initial age and bone age of GnRHa group girls were significantly lower than Mixed and GnRHa+GH groups, but their growth level was significantly higher (P < .05). In the Mixed group, starting with GnRHa alone, the predicted adult height improvement (ΔPAH) decreased to -1.0 cm in the second year, prompting addition of growth hormone (GH) therapy in the third year, resulting in a ΔPAH increase to 3.0 cm. At therapy completion, final predicted adult heights (PAHs) were similar among the groups at 155.6 to 156.7 cm, with ΔPAH between 5.8 and 6.5 cm and no significant intergroup differences (P > .05). Younger CPP girls with greater height can begin therapy with GnRHa alone. Consideration of combining GH therapy depends on growth velocity and PAH during treatment.

Secular changes in eruption of primary teeth in Chinese infants and young children from three national cross-sectional surveys.

The eruption of primary teeth is a basic event during physical development of children, which is affected by heredity and environment. This study aimed to analyze the changes in primary teeth eruption among Chinese children with social development. A total of 249,264 healthy children under 2 years were extracted from the 1995, 2005, and 2015 National Survey on the Physical Growth and Development of Children in Nine Cities of China. Their primary teeth were examined and percentiles of primary teeth eruption age were calculated by probit analysis. The median primary teeth eruption age were 6.8 months, 6.7 months, 6.6 months in 1995, 2005 and 2015. Primary teeth eruption age of boys was 0.2 months, 0.3 months, 0.3 months earlier than that of girls in 1995, 2005 and 2015. Primary teeth eruption age was the earliest in children from northern region and was the latest in children from southern region, and this regional difference did not change over time. These findings suggest that primary teeth eruption age slightly advanced with social development, and their gender difference and regional difference have always existed, which supplied some data for understanding the secular trend of primary teeth development in stomatology, pediatrics, anthropology, and other related fields.

Prediction of body mass index and skeletal maturity for early menarche risk at menarche onset: a cross-sectional study of Chinese girls.

BACKGROUND: This study aimed to assess the predictive value of body mass index (BMI) and skeletal maturity for the occurrence of early menarche in Chinese girls. METHODS: A cross-sectional analysis was conducted on 785 girls aged 8.1-14.6 years who visited our hospital within 3 months of menarche onset. Early menarche was defined as menarche age (MA) <10 years. Skeletal maturity was classified based on the difference between bone age (BA) and chronological age (CA), termed BA-CA; advanced BA was defined as BA-CA>2 years. RESULTS: The average MA was 10.7 (SD: 1.1) years, with a prevalence of early menarche of 23.3%. BA exhibited relative stability compared with MA, with an average of 12.8 (SD: 0.5) years at menarche onset. At menarche onset, the average height, weight and BMI were 149.1 (SD: 5.1) cm, 43.3 (SD: 7.2) kg and 19.4 (SD: 2.8) kg/m², respectively. Logistic regression analyses indicated that every 1-year increment in BA-CA was independently associated with a 18.90-fold higher risk of early menarche (95% CI 11.77 to 30.32), respectively, and remained statistically significant even after adjusting for height or mid-parental height. Furthermore, the prediction of BA-CA for early menarche demonstrated a dose-dependent pattern across BMI categories, with the greatest risk observed in normal-weight girls, the lowest risk in obese girls and an intermediate risk in overweight girls at the same degree of BA advancement. CONCLUSIONS: Our findings provide evidence supporting the significant contributions of BMI and skeletal maturity in predicting early menarche among Chinese girls at menarche onset. Additionally, the results suggest a dose-dependent relationship between skeletal maturity and BMI categories, with normal-weight girls displaying a higher risk of early menarche compared to overweight and obese girls with the same degree of BA advancement.

Association of height, foot length, and pubertal development in children aged 3-18: a cross-sectional survey in China.

Objective: This study aimed to analyze the growth patterns of height and foot length (FL) among Chinese children aged 3-18 and examine their associations with puberty development. Methods: A cross-sectional survey was conducted in September 2022 in Beijing. Data were collected through questionnaires and on-site physical examinations. The growth patterns and velocity of height and FL in different age groups were described, and their associations with puberty development were analyzed. Results: From an age perspective, the peak FL growth occurred between 9 and 11 years (boys were 11 years and girls were 9 years), while the peak height growth occurred at 11 ~ 13 years for boys and 9 ~ 11 years for girls. Additionally, boys and girls reached 99.0% of their final FL at the ages of 14 and 13, respectively, while they reached 99.0% of their final height at the ages of 16 and 15, respectively. From the perspective of Tanner stage, the age of peak FL growth in boys coincided with the age of the G2 stage, while in girls it occurred slightly earlier than the mean age of the B2 stage. The peak height growth for both boys and girls occurred between Tanner stages 2 and 3. Conclusion: Boys and girls reach their peak FL growth at 11 and 9 years old, respectively, which were both 2 years earlier than their peak height growth. The peak FL growth occurred around the onset of puberty, while the peak height growth occurred between Tanner stages 2 and 3.

Psychometric properties of the Chinese version of the pediatric quality of life inventory 4.0 Generic core scales among children with short stature.

BACKGROUND: The quality of life in children with short stature was rarely studied in China, so we explore these children's quality of life and psychometric properties of the Chinese version of the Pediatric Quality of Life Inventory 4.0(PedsQL4.0) Generic Core Scales among children with short stature. METHODS: A total of 201 children aged 8 ~ 18 years from the short stature clinic and other clinics of capital institute of pediatrics attended this study. The questionnaires include demographic information and PedsQL4.0 generic core scales. According to children's height, we divided them into three groups: short stature, normal short and normal group, then compared the score of scales by the height category. Moreover, we analyzed the reliability and validity of PedsQL4.0 generic core scales in these 201 children. RESULTS: The child self-report total PedsQL mean score, for the short stature, normal short and normal groups were 77.77 ± 9.69, 83.50 ± 8.56 and 87.36 ± 7.23; the parent-proxy total PedsQL mean score were 77.62 ± 10.50, 82.69 ± 8.35 and 84.91 ± 9.96 respectively. Both for children self- and parent proxy-reports, the Cronbach's α coefficients of total scale, psychosocial health and social functioning ranged between 0.74 and 0.80, it ranged between 0.51 and 0.66 in other dimensions. For child self-reports, the correlation coefficients of 17 items' scores (total 23 items) with the scores of dimensions they belong to were above 0.5, with the highest 0.759; the other 6 items' correlation coefficients were below 0.5, with the lowest 0.280. For parent proxy-reports, the correlation coefficients of 19 items' scores with the scores of dimension they belong to were above 0.5, with the highest 0.793, the other 4 items' below 0.5 with the lowest 0.243. CONCLUSIONS: The quality of life in children with short stature is worse than their normal peers by Peds QL4.0 generic core scales, the statues of their quality of life was positively related to their stature.

Comparison of updated birth weight, length and head circumference charts by gestational age in China with the INTERGROWTH-21st NCSS charts: a population-based study.

BACKGROUND: INTERGROWTH-21st 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-21st 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-21st 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 INTERGROWTH-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.

Brachydactyly Type A3 Is More Commonly Seen in Children With Short Stature But Does Not Affect Their Height Improvement by Growth Hormone Therapy.

Introduction: To analyze the prevalence of brachydactyly type A3 (BDA3) in children with short stature and the effect on growth hormone (GH) therapy. Methods: We analyzed the medical records of pediatric patients from July 2009 to July 2021. We included children with short stature defined as their height standard deviation score (HtSDS) < -2 and normal short height as their HtSDS between -2 and -1. We calculated the prevalence of BDA3 in different groups and compared the differences in children's characteristics and the therapeutic effect of GH therapy between the BDA3 and no BDA3 groups. Results: A total of 752 cases were included. The overall prevalence of BDA3 was 23.1%; with a female predominance (30.8% vs. 16.1%, P < 0.01). BDA3 was more prevalent in the short stature group (27.2%) than in the normal short stature group (16.7%) and growth hormone deficiency group (16.5%). Birth length, birth weight, HtSDS, and mid-parental height of children with BDA3 were lower than those without BDA3, but there were no significant differences. In patients with Turner syndrome and idiopathic short stature, the HtSDS of the BDA3 group was significantly lower than that of the no BDA3 group (P < 0.01). During four years of GH therapy, the HtSDS improvement per year in the BDA3 group were 0.79 ± 0.29, 0.50 ± 0.31, 0.20 ± 0.30, and 0.10 ± 0.22, which were not significantly different from those in the no BDA3 group. At the end of treatment, there were no significant differences in the duration of treatment and total HtSDS improvement between these two groups. Conclusions: BDA3 is more commonly seen in children with short stature with a female predominance. BDA3 occurrence is independent of the GH pathway and does not affect the therapeutic effect of GH on short stature children.

Growth hormone therapy in a boy with X-linked spondyloepiphyseal dysplasia tarda: a 3-year observation.

Not required for Clinical Vignette.

Stunting, wasting, overweight and their coexistence among children under 7 years in the context of the social rapidly developing: Findings from a population-based survey in nine cities of China in 2016.

The prevalence of stunting, wasting, overweight and their coexistence are various in different populations and they also have changed with social developing and environmental improving. In this paper, we aimed to analyze the prevalence of stunting, wasting, overweight and their coexistence in some developed regions of China. Data were collected in a population-based cross-sectional survey by a multi-stage cluster sampling method in nine cities located in the northern, central, and southern region of China in 2016. Children under seven years (n = 110,491) were measured. WHO growth standards were used to assess the growth status. Stunting, underweight, wasting, overweight and obesity were considered as the primary forms of malnutrition (includes undernutrition and overnutrition) for infant or young children at population-levels. The prevalence of stunting, underweight, wasting, and overweight or obesity were respectively 0.7%, 0.6%, 1.2%, and 7.6%. Most of these children (95.4%) suffered from one form of malnutrition, and only 0.2% of them concurrently stunted and wasted, 0.4% concurrently stunted and overweight, 1.7% concurrently stunted and underweight, 2.3% concurrently underweight and wasted. Among stunted children, 91.2% were appropriate body proportion, and only 2.3% were wasted, 6.5% were overweight or obesity. Among overweight or obese children, only 0.6% were stunted, whereas, 15.8% were high stature and 83.6% were the appropriate ranges of stature. Sex, age, urban/suburban, and region were associated with these primary forms of malnutrition in the multivariate logistic analysis. In conclusion, we found that the coexistence of stunting and overweight was not common at both population-level and individual-level. The situation for undernutrition had significantly improved, and overweight may be the leading public health issue for children under seven years in the nine cities of China.

Construction of China national newborn growth standards based on a large low-risk sample.

Most published newborn growth references are based on conventional monitoring data that usually included both low- and high-risk pregnancies. We sought to develop a set of neonatal growth standards constructed from only a large sample of low-risk pregnancies. A total of 24,375 naturally conceived singleton live births with gestational ages of 24-42 weeks were collected in 69 hospitals in thirteen Chinese cities between 2015 and 2018. Unhealthy infants or those with high-risk mother were excluded. Smoothed percentile curves of six anthropometric indicators were established using the Generalized Additive Model for Location, Scale and Shape. The 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile references for birth weight, length, head circumference, weight/length, body mass index, and ponderal index were calculated for neonates with gestational ages of 24-42 weeks. This set of neonatal growth standards with six anthropometric indicators can provide more tools for growth and nutrition assessment and body proportionality in neonatal clinical practice. These standards might also help to show the differences between growth curves based on low-risk and mixed low- and high-risk pregnancies.

Growth performance comparison of exclusively breastfed infants with partially breastfed and formula fed infants.

BACKGROUND: Little consensus exists for growth performance of different feeding patterns in infancy. The objective of this study is to assess the growth performance of exclusively breastfed, partially breastfed and formula fed infants in China. METHODS: Data from a total of 109,052 infants aged 1-<12 months were collected from the 4th and 5th China National Surveys in 2005 and 2015. Feeding patterns were classified into three types for infants under 6 months of age: exclusive breastfeeding, partial breastfeeding and formula feeding. Exclusive breastfeeding refers to feeding exclusively from the mother's own milk (bottle-feeding included). RESULTS: 34.0% and 43.9% of infants were exclusively breastfed and 41.5% and 36.3% were partially breastfed at 4-<6 months in 2005 and 2015 respectively. Exclusively breastfed infants were generally a little heavier than partially breastfed and formula fed infants aged 1-<6 months; however, there was not a significant statistical difference between continued breastfeeding and formula feeding infants aged 6-<12 months. No significant statistical difference for length was observed among the three groups for ages 1-<6 months; however, infants who were continued to be breastfed were a little shorter compared to those who were formula fed (ages 6-<12 months). For infants aged 1-<2 months there was not a substantial difference from the 2006 WHO growth standards; however, for infants aged 2-<12 months the average weight and length of different feeding infants in China were a little heavier and longer than the 2006 WHO growth standards. CONCLUSIONS: Partial breastfed and formula fed infants were a little lighter than exclusively breastfed infants in the first half of the first year. Formula fed infants were a little longer than continued breastfed infants in the second half.