Impact of Using Different Growth References on Interpretation of Anthropometric Parameters of Children Aged 8-15...

To compare the effect of the application of three growth references (Agarwal, 1992; Indian Academy of Paediatrics (IAP), 2015; and World Health Organisation (WHO), 2007) on interpretation of anthropometric parameters in schoolchildren.

Cross-sectional school-based study.

Children 8-15 years studying in one government school and one private school of Delhi.

The age- and gender-specific standard deviation scores of height-for-age and BMI-for-age were estimated for each student enrolled, using the three growth references independently.

The proportion of children with short stature, thinness and overweight/ obesity determined by each growth reference were compared.

A total of 1237 students participated in the study. A significantly higher proportion of children (both sexes) were classified to have short stature using WHO 2007 reference (8.8%) as compared to the Agarwal (3.3%) charts and IAP, 2015 references (3.6%). The combined prevalence of overweight and obesity was highest (34.8%) by the IAP, 2015 reference as against 32% by Agarwal charts and 29.1% by WHO, 2007 reference. Good agreement existed between the IAP, 2015 reference and Agarwal charts in classifying subjects into different BMI categories (Kappa=0.82) and short stature (Kappa=0.99).

In view of differences noted, use of national population derived reference data is suggested to correctly define growth trajectories in children.