2000 CDC Growth Charts for the United States: methods and development

Area of Science:

• Pediatrics
• Public Health
• Biostatistics

Background:

• The 1977 National Center for Health Statistics (NCHS) growth charts required revision to reflect current U.S. population demographics and feeding practices.
• Previous growth charts did not adequately represent the racial-ethnic diversity and infant feeding methods prevalent in the United States.

Purpose of the Study:

• To detail the development process of the 2000 Centers for Disease Control and Prevention (CDC) growth charts.
• To introduce revised growth charts for infants and children, including new Body Mass Index-for-age (BMI-for-age) charts.
• To provide updated tools for monitoring child growth and development.

Main Methods:

• Utilized data from five national health examination surveys and supplemental data.
• Employed a two-stage smoothing process for percentile curves using parametric and nonparametric procedures.
• Evaluated smoothed percentile curves against empirical data using statistical and graphical measures.

Main Results:

• Revised growth charts for infants (0-36 months) and children (2-20 years) were created.
• New BMI-for-age charts were introduced.
• The revised charts demonstrated improved transitions between age groups and showed no significant discrepancies with empirical data.

Conclusions:

• The 2000 CDC growth charts incorporate enhanced data and statistical methodologies.
• These charts offer a more accurate representation of growth patterns in the diverse U.S. population, considering various feeding practices.
• It is recommended that healthcare providers adopt the 2000 CDC growth charts, replacing the 1977 NCHS charts for comprehensive growth assessment.