Monitoring head size and growth using the new UK-WHO growth standard

Area of Science:

• Pediatrics
• Public Health
• Growth Monitoring

Background:

• Accurate head circumference measurement is crucial for monitoring infant development.
• Existing growth standards may differ in their identification of normal versus abnormal head growth patterns.
• The UK-WHO and UK1990 references are commonly used standards for assessing infant head circumference.

Purpose of the Study:

• To compare the UK-WHO head circumference standard with the UK1990 reference in a UK population.
• To assess the prevalence of large head circumference and rapid head growth using both standards.
• To inform healthcare practitioners about potential discrepancies in growth assessment.

Main Methods:

• Utilized head circumference data from two large UK cohorts: Southampton Women's Survey (n=3159) and Avon Longitudinal Study of Parents and Children (n=15208).
• Analyzed data from children aged 0-36 months.
• Calculated z-scores using both UK-WHO and UK1990 references, defining rapid head growth as crossing two major centile bands (1.33 SD).

Main Results:

• The UK-WHO standard identified a higher percentage of infants with heads above the 98th centile (6-16%) compared to the UK1990 reference (1-4%).
• Rapid head growth in the first 6-9 months was significantly more common with the UK-WHO standard (14.6-15.3%) than the UK1990 reference (4.8-5.1%).

Conclusions:

• The UK-WHO head circumference standard identifies a greater proportion of infants with large head circumference and rapid growth compared to the UK1990 reference.
• Practitioners need to be aware of these differences to avoid misinterpretation and unnecessary referrals.
• These findings highlight the importance of using appropriate and updated growth standards in pediatric care.