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[Effect of changing reference growth charts on the prevalence of short stature]
Pilar Aizpurua Galdeano1, Maider Mateo Abad2, Ángeles Alonso Alonso1
1Centro de Salud Ondarreta, San Sebastián, Guipúzcoa, España.
Insights
Changing growth charts significantly increased short stature diagnoses by sixfold. This highlights the impact of updated diagnostic tools on identifying children needing further evaluation for growth concerns.
Area of Science:
- Pediatrics
- Growth and Development
- Public Health
Background:
- Short stature is a common pediatric concern, necessitating accurate diagnostic tools like growth charts.
- Evaluating the impact of updated reference charts is crucial for consistent diagnosis in pediatric care.
Purpose of the Study:
- To assess how the transition from 2004 to 2011 reference growth charts affected the diagnosis of short stature in a specific health region.
- To quantify the change in short stature prevalence following the adoption of new growth charts.
Main Methods:
- A population-based, cross-sectional study compared height data from 12,256 children (aged 4, 6, 10, 13) against 2004 and 2011 growth charts.
- Prevalence of short stature and the 3rd percentile were calculated for both chart versions.
Main Results:
- The prevalence of short stature increased across all age groups with the 2011 charts compared to the 2004 charts.
- Diagnoses rose from 58 (2004 charts) to 352 (2011 charts), a sixfold increase.
- Prevalence differences ranged from 1.4% to 3.6% across the studied ages.
Conclusions:
- The updated 2011 growth charts led to a substantial sixfold increase in short stature diagnoses.
- This shift necessitates evaluating the clinical significance and suitability of the new charts for identifying potential growth disorders.
Introduction:
Short stature is a family concern, and is a common reason for consultations in paediatrics. Growth charts are an essential diagnostic tool. The objective of this study is to evaluate the impact of changing reference charts in the diagnosis of short stature in a health area.
Subjects And Methods:
A population-based-cross-sectional-descriptive-study was performed in which the height of children of 4, 6, 10 and 13 years-old were compared with the growth charts of the Fundación Orbegozo 2004 Longitudinal and 2011. The prevalence of short stature and the 3rd percentile of the study sample were calculated.
Results:
There were 12,256 valid records (89% of the population). The prevalence of short stature increased at all ages with the change in the growth charts, with differences of prevalence of 3.6% (95% CI: 2.8 to 4.5) at 4 years; 1.8% (95% CI: 1.3 to 2.3) at 6 years; 2.8% (95% CI: 2.2 to 3.4) at 10 years, and 1.4% (95% CI: 0.8 to 1.9) at 13 years. In absolute numbers, it went from 58 diagnoses of short stature with the 2004 Longitudinal charts (34 boys and 24 girls) to 352 with the 2011 (155 boys and 197 girls).
Conclusions:
The change in reference growth charts has increased by 6-fold the number of diagnoses of short stature. The pathological condition found in the cases diagnosed with the 2011 growth charts that had not been diagnosed with the previous charts will allow us to evaluate the suitability of the change.
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