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Field Testing of IAP2015 Charts
Nikhil Lohiya1, Vaman Khadilkar2, Shubhadarshini Pawar1
1Department of Pediatric Endocrinology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India.
Insights
The Indian Academy of Pediatrics 2015 (IAP2015) growth charts accurately represent current children across socioeconomic groups. These IAP2015 charts are recommended for precise child growth assessment, avoiding misclassification of nutritional status.
Area of Science:
- Pediatric Nutrition
- Growth Monitoring
- Anthropometry
Background:
- Accurate growth charts are essential for monitoring child development and nutritional status.
- Existing growth references, such as World Health Organization (WHO) and Indian Academy of Pediatrics 2007 (IAP2007) charts, may not reflect the current generation of children accurately.
- Variations in socioeconomic status can influence anthropometric measurements and growth patterns.
Purpose of the Study:
- To evaluate the performance of the Indian Academy of Pediatrics 2015 (IAP2015) growth charts across diverse socioeconomic strata.
- To compare Z-scores for height, weight, and Body Mass Index (BMI) for age derived from IAP2015 charts against those from IAP2007 and WHO charts.
- To assess the representativeness of IAP2015 charts for contemporary Indian children.
Main Methods:
- A cross-sectional observational study was conducted in Pune, India.
- Anthropometric measurements (height, weight) were collected from apparently healthy children aged 5-18 years from urban affluent, urban underprivileged, and rural populations.
- Standard deviation scores (Z-scores) for height-for-age, weight-for-age, BMI-for-age were calculated using IAP2015, IAP2007, and WHO growth charts.
Main Results:
- Significant differences in anthropometric parameters were observed across socioeconomic groups, with urban affluent children being tallest and heaviest, and urban underprivileged children being shortest.
- Children exhibited shorter stature on WHO references and taller stature on IAP2007 references.
- BMI Z-scores were higher on IAP2007 charts and lower on WHO references. The IAP2015 charts classified the highest proportion of urban affluent children within the reference range.
- WHO references led to overestimation of stunting and wasting, while IAP2007 charts underestimated these conditions. Both WHO and IAP2007 charts classified fewer children as obese/overweight compared to IAP2015.
Conclusions:
- The IAP2015 growth charts serve as a better representation of healthy children in the current generation.
- Utilizing IAP2015 charts can help prevent inappropriate classification of children's growth and nutritional status.
- These updated charts are recommended for use in clinical practice and public health initiatives for accurate child growth monitoring.
Objectives:
To field test the IAP2015 (Indian Academy of Pediatrics) charts in different socioeconomic classes; to compare standard deviation scores (Z-scores) of children's height, weight and body mass index (BMI) for age as computed based on IAP2007 or WHO charts against the IAP2015 references.
Methods:
A cross-sectional observational study was conducted in the district of Pune on apparently healthy 5-18 y old children from urban affluent, urban underprivileged and rural areas. Anthropometric measurements were performed and parameters were converted into Z-scores.
Results:
Urban affluent children were tallest and heaviest whereas urban underprivileged children were shortest. Z-score comparison showed that all children were shortest on WHO references and taller as per IAP2007 references. BMI Z-score was higher on IAP2007 charts and lower on WHO references. Highest number of children were within the reference range on IAP2015 charts among urban affluent. More children were classified stunted on WHO references and least on IAP2007 references. WHO references overestimated wasting and as per IAP2007 charts, less number were wasted. Less number of children were classified as being obese/overweight by WHO and IAP2007 references.
Conclusions:
IAP2015 charts are better representative of healthy children of current generation and may be used to prevent inappropriate classification in present scenario.
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