Weight Estimation Methods in Children: A Systematic Review

We seek to collect, review, evaluate, and synthesize the current literature focusing on all published methods of pediatric weight estimation.

We conducted a literature review using PubMed and Web of Science databases, and the Google Scholar search engine, with the "similar articles" feature, as well as review of the bibliographies of identified studies. We excluded studies estimating weight of neonates, predominantly adults without separate information for children, child self-reported weight, and studies estimating outcomes other than weight. Quantitative outcomes of accuracy (proportion within 10% of actual weight), mean percentage error, and mean bias were preferred.

Eighty studies met inclusion criteria with predominant methods: parent or health care worker weight estimation, age-based formulae, and length-based estimation without (eg, Broselow) or with adjustment for body habitus (eg, Pediatric Advanced Weight-Prediction in the Emergency Room, Mercy). Parent estimation was the most accurate at predicting total (actual) body weight, with length-based methods with habitus adjustment next. Length-based methods outperformed age-based formulae, and both tended to underestimate the weight of children from populations with high obesity rates and overestimate the weight of children from populations with high malnourishment rates. Health care worker estimation was not accurate.

Parent estimation and length-based methods with adjustment for body habitus are the most accurate methods to predict children's total (actual) body weight. Age-based formulae and length-based methods without habitus adjustment likely tend to predict ideal body weight.