最近几次随访评估发现,到了上学年龄的生长停滞的大多数孩子,虽然许多人仍然会比同龄人矮,但有正常的体重。[1]Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC growth charts for the United States: methods and development. Vital Health Stat 11. 2002 May;(246):1-190.http://www.cdc.gov/nchs/data/series/sr_11/sr11_246.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/12043359?tool=bestpractice.com[3]Waterlow JC, Buzina R, Keller W, et al. The presentation and use of height and weight data for comparing the nutritional status of groups of children under the age of 10 years. Bull World Health Organ. 1977;55(4):489-98.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2366685/http://www.ncbi.nlm.nih.gov/pubmed/304391?tool=bestpractice.com
考量认知和学习成绩时,来源于初级保健或社区网站招募的生长停滞的学龄儿童,其平均智商大约比正常生长的儿童低4分。[3]Waterlow JC, Buzina R, Keller W, et al. The presentation and use of height and weight data for comparing the nutritional status of groups of children under the age of 10 years. Bull World Health Organ. 1977;55(4):489-98.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2366685/http://www.ncbi.nlm.nih.gov/pubmed/304391?tool=bestpractice.com[6]Wright CM. Identification and management of failure to thrive: a community perspective. Arch Dis Child. 2000 Jan;82(1):5-9.http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1718189&blobtype=pdfhttp://www.ncbi.nlm.nih.gov/pubmed/10630901?tool=bestpractice.com[8]Cook JT, Frank DA, Levenson SM, et al. Child food insecurity increases risks posed by household food insecurity to young children's health. J Nutr. 2006 Apr;136(4):1073-6.http://jn.nutrition.org/cgi/reprint/136/4/1073http://www.ncbi.nlm.nih.gov/pubmed/16549481?tool=bestpractice.com[28]Corbett SS, Drewett RF. To what extent is failure to thrive in infancy associated with poorer cognitive development? A review and meta-analysis. J Child Psychol Psychiatry. 2004;45:641-654.http://www.ncbi.nlm.nih.gov/pubmed/15055382?tool=bestpractice.com 这些研究结果表明早期生长停滞可能导致身长矮小,虽然对认知表现有潜在的重要影响,早期专注于住院儿童的研究显示并不引起严重的缺陷。
一项近期的关于生长停滞儿童前2年的随访显示,到8岁时生长停滞的儿童更矮、更瘦,并且与没有生长停滞的儿童相比具有较低的数学成绩。[29]Black MM, Dubowitz H, Krishnakumar A, et al. Early intervention and recovery among children with failure to thrive: follow-up at age 8. Pediatrics. 2007;120:59-69.http://www.ncbi.nlm.nih.gov/pubmed/17606562?tool=bestpractice.com 然而智商、阅读或行为问题没有组间差异。 家庭干预部分缓解8岁时生长停滞对儿童身高、体质指数、数学成绩、学校行为的负面影响。[29]Black MM, Dubowitz H, Krishnakumar A, et al. Early intervention and recovery among children with failure to thrive: follow-up at age 8. Pediatrics. 2007;120:59-69.http://www.ncbi.nlm.nih.gov/pubmed/17606562?tool=bestpractice.com 其中唯一的随访儿童进入青春期的研究发现生长停滞对儿童长期的教育效应与混杂因素有关,表明生长停滞在贫困的背景下为风险因素,但在资源丰富的背景下,生长停滞并不是主要的关注问题。[30]Holme AR, Blair PS, Emond AM. Psychosocial and educational outcomes of weight faltering in infancy in ALSPAC. BMJ Open. 2013;3:e002863.http://bmjopen.bmj.com/content/3/7/e002863.longhttp://www.ncbi.nlm.nih.gov/pubmed/23833121?tool=bestpractice.com