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A new Swedish reference for total and prepubertal height.

Kerstin Albertsson-Wikland1, Aimon Niklasson2, Anton Holmgren2,3

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New height references for children provide more accurate growth monitoring. These updated standards, including prepubertal and total height standard deviation scores (SDS), improve upon current Swedish and World Health Organization (WHO) references.

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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.