Growth reference charts for use in the United Kingdom

Area of Science:

• Paediatrics
• Child Health
• Growth Monitoring

Background:

• Confusion exists regarding the appropriate use of pediatric growth charts introduced in the mid-1990s.
• Multiple versions of growth charts are employed by various districts, leading to inconsistencies.
• The Royal College of Paediatrics and Child Health established the Growth Reference Review Group to address this uncertainty.

Purpose of the Study:

• To evaluate the validity and comparability of different pediatric growth charts.
• To provide guidance on the selection of appropriate growth references for British children.
• To assess the reliability of existing growth charts against contemporary pediatric data.

Main Methods:

• Review of the technical construction and evaluation methodologies of growth charts.
• Assessment of growth chart validity using data from contemporary British children.
• Comparative analysis of the UK90, Tanner-Whitehouse, and Gairdner-Pearson growth references.

Main Results:

• The UK90 reference is deemed superior for most clinical applications and measures in British children.
• The original Tanner-Whitehouse and Gairdner-Pearson charts are considered unreliable for all age groups.
• Revised Buckler-Tanner references remain suitable for height assessment after age two.
• No reliable head circumference reference charts are available for use beyond infancy.

Conclusions:

• The UK90 growth reference is the primary recommendation for clinical use in British children.
• Existing older growth charts (Tanner-Whitehouse, Gairdner-Pearson) are obsolete.
• Future revisions of growth charts should be carefully planned and involve broad consultation, with the UK90 reference being "frozen" in the interim.