A new Swedish reference for total and prepubertal height

Area of Science:

• Pediatric endocrinology
• Growth and development studies
• Biostatistics and reference standard development

Background:

• Accurate growth monitoring is crucial for identifying growth disorders in children.
• Existing height references may not reflect current population growth patterns, potentially leading to misinterpretation of growth trajectories.
• The need for updated, reliable height references, particularly for prepubertal and total height, is recognized.

Purpose of the Study:

• To develop contemporary standard deviation score (SDS) references for prepubertal and total height in children.
• To establish new growth references based on a modern cohort to improve the accuracy of growth assessment.
• To provide updated benchmarks for evaluating child growth trajectories from birth to adulthood.

Main Methods:

• Longitudinal height data from 1572 healthy children (born 1989-1991) were analyzed.
• A total height standard deviation score (SDS) reference was constructed using Quadratic-Exponential-Pubertal-Stop (QEPS) functions.
• A prepubertal height SDS reference was developed using Quadratic-Exponential (QE) functions to represent growth without pubertal influence.

Main Results:

• The new total height reference indicated taller mean prepubertal heights compared to the 1974 Gothenburg reference.
• Adult height estimates increased by 0.9 cm for women and 1.6 cm for men.
• Significant differences were observed in height measurements at -2 SDS compared to previous Swedish and World Health Organization (WHO) references, highlighting potential discrepancies in growth assessment.

Conclusions:

• The developed up-to-date total and prepubertal height references offer enhanced accuracy for growth monitoring.
• These new references have the potential to improve the identification and management of growth deviations in pediatric populations.
• Implementation of these updated references is recommended for clinical practice in Sweden.