Euro-Growth references for length, weight, and body circumferences. Euro-Growth Study Group

Several concerns have been raised by World Health Organization (WHO) expert groups regarding the adequacy of currently existing growth references, including those currently supported by WHO. As part of a concerted action of the European Union, new references were developed that were based on a well-defined sample of the European population and were compared with existing references.

During the longitudinal, observational multicenter study, anthropometric measurements using standardized methodology were performed in 2,245 children between 1 and 36 months of age, and sex- and age-specific growth references for recumbent length, weight, mid-upper arm, thigh, and calf circumferences were developed.

The validity of the curve-fitting programs was demonstrated by comparing the selected sex-specific percentile distributions for all indices with the smoothed references. Comparison with the National Center for Health Statistics (NCHS)-WHO references for length and weight for age indicated that the -2 z-score value of the WHO reference as cutoff value shows that a substantial part of the children with suspected failure to thrive should be classified as normal. The references also indicate that the mid-upper arm circumference is age and sex dependent and that a single cutoff value for children less than 5 years of age should no longer be used. Mid-parental height was the best single predictor of recumbent length until 36 months of age.

The Euro-Growth references that were developed reflect growth of a well-defined, large cohort of healthy infants and can be used for international comparisons.