儿童生长曲线的发展历程、构建方法与应用

doi:10.12372/jcp.2026.25e0686

Abstract

Abstract:

Growth curves are indispensable for monitoring children's growth in child health care and pediatrics. In our article, we traces growth curves ranging over 200 years, from the hand-drawn charts in the early 18th century to algorithmic modeling in modern ages, highlighting their crucial role in assessing child health. China has made progress in growth curves research, with localized versions better reflecting domestic children's growth patterns, especially in detecting growth retardation in rural populations. In this article we also introduce growth curves construction methods, including non - parametric approaches (e.g., cubic spline, penalized splines, kernel estimation, LOWESS/LOESS) and parametric approaches (e.g., LMS, GAMLSS), comparing their merits, limitations, and applicability. Future research will focus on creating individualized growth curves and building localized standards to enhance assessment accuracy, thereby better supporting child health monitoring and disease prevention.

Key words: growth curves, child growth and development, growth monitoring

CLC Number:

GAO Yufei, QIAN Naisi, YANG Zhiyu, JIN Shan, LU Huiping, WU Cheng, SONG Hualing, YU Huiting. Child growth curves: historical development, construction methodologies, and applications[J].Journal of Clinical Pediatrics, 2026, 44(4): 373-380.

Figures/Tables 2

References 43

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方法	优势	局限性	适用场景
三次样条法	（1）无需分布假设；（2）适合处理复杂的非线性关系	只反映平均趋势，百分位数需估计	适用于数据点较为密集且分布均匀的情况
LMS法	（1）沿用百分位数法，结果直观且便于解释；（2）支持Z值转换，提高不同个体、群体间差异的可比性；（3）各相邻百分位数值间不会出现交叉、颠倒或重叠，提高了正常值或标准的精确性	分布假设局限，协变量处理缺乏灵活性	广泛用于人体测量数据的生长曲线建模，尤其是在需要考虑偏度和构建百分位数曲线时
GAMLSS法	（1）多参数建模，对中位数、标准差、偏度系数和峰度系数等四阶矩进行建模，提供更全面的曲线描述；（2）兼容多种分布，适应复杂数据形态，灵活性强；（3）支持多协变量及非参数平滑项	需较大样本量，复杂模型收敛困难	适用于具有明显偏度和峰度特征或有多个协变量等结构复杂的数据，如特殊人群生长曲线

Child growth curves: historical development, construction methodologies, and applications

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