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Updated: Nov 25, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
A big-data approach to producing descriptive anthropometric references: a feasibility and validation study of
Barbara Heude1, Pauline Scherdel2, Andreas Werner3
1Early Life Origins of Health Research Team, Université de Paris, Paris, France.
Insights
New French pediatric growth charts, developed using a big-data approach, show improved calibration compared to existing WHO and national charts. These charts offer a more accurate assessment of child physical growth in France.
Area of Science:
- Pediatric Health
- Biostatistics
- Public Health
Background:
- Existing national and WHO growth charts demonstrate poor calibration with physical growth in many countries.
- Accurate growth charts are essential for monitoring child development and identifying potential health issues.
Purpose of the Study:
- To generate new, accurately calibrated national growth charts for French children.
- To address the limitations of current growth assessment tools in the French pediatric population.
Main Methods:
- Utilized a large dataset of anonymized physical growth measurements from French children (born 1990-2018).
- Employed generalized additive models with the Box-Cox power exponential distribution to derive new weight and height charts.
- Data cleaning and validation against existing French and WHO charts, and national cross-sectional surveys were performed.
Main Results:
- Included over 1.4 million height and 1.6 million weight measurements from more than 238,000 children.
- New charts showed significantly higher height and weight percentile curves compared to existing French national charts.
- Validation confirmed satisfactory calibration with national cross-sectional survey data.
Conclusions:
- Successfully developed calibrated pediatric growth charts for French children using a novel big-data approach.
- The new charts, derived from routinely collected clinical data, offer improved accuracy for assessing physical growth.
- This methodology has potential applications beyond anthropometry in various health fields.
Background:
Both national and WHO growth charts have been found to be poorly calibrated with the physical growth of children in many countries. We aimed to generate new national growth charts for French children in the context of huge datasets of physical growth measurements routinely collected by office-based health practitioners.
Methods:
We recruited 32 randomly sampled primary care paediatricians and ten volunteer general practitioners from across the French metropolitan territory who used the same electronic medical records software, from which we extracted all physical growth data for the paediatric patients, with anonymisation. We included measurements from all children born from Jan 1, 1990, and aged 1 month to 18 years by Feb 8, 2018, with birthweight greater than 2500 g, to which an automated process of data cleaning developed to detect and delete measurement or transcription errors was applied. Growth charts for weight and height were derived by using generalised additive models for location, scale, and shape with the Box-Cox power exponential distribution. We compared the new charts to WHO growth charts and existing French national growth charts, and validated our charts using growth data from recent national cross-sectional surveys.
Findings:
After data cleaning, we included 1 458 468 height and 1 690 340 weight measurements from 238 102 children. When compared with the existing French national and WHO growth charts, all height SD and weight percentile curves for the new growth charts were distinctly above those for the existing French national growth charts, as early as age 1 month, with an average difference of -0·75 SD for height and -0·50 SD for weight for both sexes. Comparison with national cross-sectional surveys showed satisfactory calibration, with generally good fit for children aged 5-6 years and 10-11 years in height and weight and small differences at age 14-15 years.
Interpretation:
We successfully produced calibrated paediatric growth charts by using a novel big-data approach applied to data routinely collected in clinical practice that could be used in many fields other than anthropometry.
Funding:
The French Ministry of Health; Laboratoires Guigoz-General Pediatrics section of the French Society of Pediatrics-Pediatric Epidemiological Research Group; and the French Association for Ambulatory Pediatrics.
