Growth charts compared

Area of Science:

• Pediatric endocrinology and growth monitoring
• Public health and child development assessment

Background:

• Child growth assessment relies on comparing measurements to normative references, typically growth charts.
• Traditional growth charts (references) are geographically specific, reflecting 'normal' growth in a defined area.
• The World Health Organization (WHO) has developed new growth charts as global standards.

Purpose of the Study:

• To compare existing national growth references with new multinational growth standards.
• To investigate the reasons for differences between various growth charts.
• To assess the impact of these differences on individual and group child health assessments.

Main Methods:

• Comparative analysis of five different growth charts: UK, Netherlands, USA (national references), Euro-Growth (multinational reference), and WHO (multinational standard).
• Examination of methodological differences, including prescriptive approaches and data truncation.
• Evaluation of the clinical significance of chart discrepancies in different assessment contexts.

Main Results:

• Significant, largely unexplained differences exist between the WHO growth standard and traditional national growth references.
• Differences are partially attributable to the WHO's prescriptive approach and data handling methods.
• Discrepancies have minimal impact on monitoring individual child growth but are substantial for group health assessments.

Conclusions:

• The new WHO growth charts represent a global standard for optimal child growth under ideal conditions.
• While differences between growth charts may be trivial for individual monitoring, they significantly affect population-level health assessments.
• Further research is needed to fully understand the unexplained variations between different growth assessment tools.