CDC growth charts: United States.

Area of Science:

• Pediatrics and Public Health
• Growth Monitoring and Assessment

Background:

• The 1977 National Center for Health Statistics (NCHS) growth charts required revision due to evolving population demographics and data collection methods.
• Previous charts did not fully represent the diversity of the U.S. population or account for contemporary feeding practices.

Purpose of the Study:

• To present revised United States growth charts for infants and children.
• To detail the history, rationale, data, and methodologies behind the updated growth charts.

Main Methods:

• Combined data from multiple national health examination surveys (1963-1994) and supplementary sources.
• Employed a two-stage statistical approach, including parametric and nonparametric smoothing, to generate percentile curves and z-scores.
• Utilized a normalization procedure for precise alignment of z-scores with smoothed percentile curves.

Main Results:

• Introduced revised NCHS growth charts, including new body mass index-for-age (BMI-for-age) charts for boys and girls.
• Incorporated national survey data, enhancing representation of racial/ethnic diversity and combined breast/formula-fed infant growth patterns.
• Added 3rd and 97th percentiles and extended charts to age 20 years for comprehensive assessment.

Conclusions:

• The revised U.S. growth charts provide an enhanced and more accurate tool for evaluating infant and child size and growth.
• Improved data sources and advanced statistical techniques ensure greater reliability and applicability of the updated charts.