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New Finnish reference for head circumference from birth to 7 years
Marjo Karvonen1, Marja-Leena Hannila, Antti Saari
1Department of Pediatrics, School of Medicine, University of Eastern Finland, Kuopio, Finland.
Insights
Updated Finnish head circumference (HC) growth charts show increased HC for age, particularly after two years. These new references are essential for accurately monitoring child growth in Finland.
Area of Science:
- Pediatrics
- Growth Monitoring
- Public Health
Background:
- Current Finnish head circumference (HC) growth charts are outdated, based on limited data from 1953-1964.
- Secular trends in HC growth necessitate updated reference data for accurate assessment.
Purpose of the Study:
- To update Finnish head circumference (HC) for age growth charts using contemporary data.
- To establish new references for HC and HC/height ratio for age in children aged 0-7 years.
Main Methods:
- Utilized mixed cross-sectional data from 19,715 healthy children aged 0-7 years.
- Employed generalized additive models for location, scale, and shape (GAMLSS) to fit reference curves.
Main Results:
- Contemporary Finnish children exhibit increased HC for age, especially after two years, compared to older charts.
- The standard deviation for HC was significantly larger in the older 1953-1964 reference data.
- A higher proportion of children in the new reference group exceeded the +2 SD limit of the older reference.
Conclusions:
- Periodic renewal of HC growth references is crucial due to observed secular changes.
- The newly developed Finnish HC for age reference charts should be implemented for clinical monitoring of child growth.
Background And Objectives:
In the evaluation of the growth of head circumference (HC), charts depicting normal growth are of paramount importance. Current Finnish HC growth charts are based on data from only 130 children born 1953-1964. As a secular trend in HC growth has been reported, we updated the HC charts using a large sample of contemporary HC data.
Material And Methods:
Mixed cross-sectional HC data of 19,715 healthy subjects aged 0-7 years were collected from primary health care providers. References for HC for age and HC/height ratio for age were fitted using generalized additive models for location, scale, and shape (GAMLSS).
Results:
Increased HC for age was seen particularly after 2 years of age in both genders compared to the 1953-1964 reference. The SD for HC was remarkably larger in the 1953-1964 reference. The proportion of 1986-2008 reference subjects exceeding the +2 SD limit of the 1953-1964 reference was much bigger than the proportion below -2 SD.
Conclusions:
Because of the secular change in HC growth, the HC reference has to be renewed periodically. The new Finnish reference for HC for age should be implemented for monitoring HC growth of children in Finland.
