Approaches to detecting growth faltering in infancy and childhood
1Department of Mathematical Sciences, University of Durham, UK. Jennifer.Argylle@durham.ac.uk
Insights
Detecting growth faltering in children requires assessing weight and height changes over time. Conditional gain Z-scores offer the most flexible mathematical approach for evaluating longitudinal growth patterns.
Area of Science:
- Pediatrics
- Growth Monitoring
- Biostatistics
Background:
- Childhood growth monitoring is crucial for detecting growth faltering.
- Infancy focuses on weight gain for failure-to-thrive risk, while childhood emphasizes height gain, such as response to growth hormone treatment.
- Cross-sectional charts are insufficient for longitudinal growth assessment.
Purpose of the Study:
- To review and compare mathematical approaches for detecting growth faltering in children.
- To evaluate the relative merits of various methods for assessing longitudinal growth patterns.
Main Methods:
- Review of mathematical approaches for growth assessment.
- Discussion of velocity/increment references, conditional gain Z-scores, infancy weight-monitoring charts, LGROW package norms, tracking indices, distance charts, and centile crossing.
Main Results:
- Conditional gain Z-scores are identified as the most flexible method for assessing growth patterns.
- Various mathematical approaches exist for evaluating longitudinal growth, each with specific applications.
Conclusions:
- Accurate assessment of child growth requires longitudinal data and appropriate mathematical tools.
- Conditional gain Z-scores provide a robust framework for analyzing growth trajectories and identifying faltering.
Abstract:
One of the purposes of monitoring a child's weight or height is to detect growth faltering. In infancy the focus is on monitoring weight gain, primarily for detecting infants at risk of failure-to-thrive. In childhood, this switches to height gain, e.g. the response of a child that is growth hormone deficient to treatment with growth hormone. Cross-sectional charts provide no guidance in a longitudinal context. If we note the current weight or height of a child, but want to say something about a child's growth since the last weight and height measurement, we need to use a velocity/increment reference or take a conditional approach to the problem. Here we focus on growth faltering and review the mathematical approaches to this problem. Discussion will concentrate on the relative merits of the following approaches: velocity references and increment charts or tables; conditional gain Z-scores;infancy weight-monitoring charts and longitudinal growth norms implemented in the growth package LGROW; tracking indices and distance charts and centile crossing. Overall conditional gain Z-scores provide the most flexible means of assessing growth patterns.
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