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Updated: Sep 25, 2026

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Euro-Growth references for body mass index and weight for length. Euro-Growth Study Group
1Department of Paediatrics, University of Vienna, Austria.
Insights
New Euro-Growth references for body mass index (BMI) and weight for length (WfL) were developed using longitudinal data from 2145 children. These sex-specific charts offer improved tools for assessing childhood growth and obesity during the first 36 months of life.
Area of Science:
- Pediatric growth assessment
- Anthropometry
- Childhood obesity research
Background:
- Longitudinal data from the multicenter Euro-Growth study (n=2145) were utilized.
- The study included 21 diverse study sites.
Purpose of the Study:
- To develop sex-specific percentiles and Z-scores for body mass index (BMI) and weight for length (WfL).
- To establish growth references for infants during the first 36 months of life.
Main Methods:
- Smoothed percentile curves for BMI and WfL were constructed and validated against raw data.
- Relationships between BMI, length, WfL, and age were examined.
- Influence of gender, geography, and genetics on growth parameters was assessed.
- New references were compared with existing NCHS references.
Main Results:
- BMI percentiles showed a rapid increase from 1-6 months, followed by a decline from 12-36 months.
- WfL percentiles closely matched raw data; BMI was largely independent of length, while WfL showed age dependence.
- Geographic location had a modest influence; parental factors showed weak correlations.
- Euro-Growth references provided a wider range compared to NCHS references.
Conclusions:
- The developed Euro-Growth references for BMI and WfL offer enhanced tools for healthcare professionals.
- These references are valuable for monitoring childhood growth and identifying obesity in early life.
Background:
Fully longitudinal data from the multicenter Euro-Growth study (21 study sites; n = 2145 children) were used to develop sex-specific percentiles and Z-scores for body mass index (BMI) and weight for length (WfL) during the first 36 months of life.
Methods:
Smoothed percentile curves for BMI against age were constructed and checked against raw percentiles. Smoothed percentile curves for WfL were constructed according to established procedures and were checked against raw percentiles. The relation of BMI with length and of WfL with age was examined. The relation between BMI and WfL was tested using z-scores of each. The influence of gender, geographic location (study site), and genetic factors on BMI and WfL was examined. Finally, the new references for BMI and WfL were compared with other published references.
Results:
Selected percentiles (P; P3, P5, P10, P25, P50, P75, P90, P95, and P97) for BMI showed a sharp increase from 1 to 6 months of age and a gradual decline between 12 and 36 months. Smoothed percentiles for WfL showed only small deviations from raw percentiles. BMI was found to be essentially independent of length, whereas WfL showed some degree of dependence on age. Values for BMI and WfL showed very good agreement, except at the extremes of the age range. A modest degree of influence of geographic location on BMI and WfL was found. Correlations with parental BMI and WfL were very weak, however. Comparison with the National Center for Health Statistics (NCHS) references showed the latter to have a narrower range of values.
Conclusions:
The new Euro-Growth references for BMI and WfL provide improved tools for health workers and researchers dealing with childhood obesity.
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