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Developing growth reference charts for the head circumference of Pakistani children aged 6 to 18 years
Muhammad Asif1, Muhammad Aslam2, Tariq Ismail3
1Department of Statistics, Govt. Degree College, Qadir Pur Raan, Multan, Pakistan.
Insights
Pakistani children aged 6-18 have smaller head circumference (HC) percentiles compared to other countries. This study developed specific HC reference curves for Pakistani children, highlighting the need for country-specific growth charts.
Area of Science:
- Pediatric anthropometry
- Growth monitoring
- Neurological development assessment
Background:
- Head circumference (HC) is crucial for assessing brain volume and predicting developmental/neurological disorders in children.
- Existing HC reference curves may not accurately represent diverse populations.
- Establishing population-specific HC data is vital for accurate child health evaluations.
Purpose of the Study:
- To develop smoothed reference curves for head circumference (HC) in Pakistani children aged 6 to 18 years.
- To provide accurate anthropometric data for Pakistani pediatric populations.
- To address the lack of localized HC growth charts.
Main Methods:
- Utilized a cross-sectional dataset of 9,194 school-going children (ages 6-18).
- Employed standard procedures for head circumference (HC) measurement in centimeters.
- Applied the lambda-mu-sigma (LMS) statistical approach to generate smoothed centile curves for both sexes.
- Compared Pakistani HC data with international references (US, Turkey).
Main Results:
- HC increased with age in both boys and girls.
- Boys exhibited larger HC percentiles than girls until age 10.
- From age 11, girls showed higher upper percentiles (90th, 95th, 97th) than boys.
- Pakistani children had smaller HC measurements across all ages compared to US and Turkish children.
Conclusions:
- Significant disparities in HC percentiles exist between different countries.
- International HC references (e.g., US CDC) are unsuitable for Pakistani children.
- Developing country-specific HC reference curves is essential for accurate pediatric health assessment.
Background:
Head circumference (HC) measurement is a significant measure of brain volume. It is also considered a powerful predictor in the evaluation of developmental and neurological disorders in children. This study aims to develop smoothed reference curves for HC of the Pakistani children of age 6 to 18 years.
Methods:
A cross-sectional dataset, consisting of 9194 school-going children of age 6-18 years, were obtained using a multi-ethnic anthropometric survey. For the measurement of HC (cm), the standard procedure was adopted. For both sexes, the smoothed centile curves of HC were developed by using the lambda-mu-sigma (LMS) statistical approach. Moreover, we compared our 50th percentile curves to those produced for few other countries.
Results:
The centiles curves of both sexes indicated that the HC increased with age. Until the age of 10 years, the boys had larger HC percentiles than those of the girls. From the age of 11 years, upper percentiles (90th, 95th and 97th) of the girls were higher than those of the boys. The comparison of our 50th percentile data for the HC with the data from the United States (US) and Turkish children revealed that the Pakistani children of both genders had smaller head sizes in all ages when compared to those reported for the latter stated countries.
Conclusions:
Our results show the larger disparity of HC percentiles in different countries. This comprehensive study suggests that the references from the US Centers for Disease Control and Prevention data and other populations are not suitable for Pakistani children. Therefore, each country is required to create its own HC reference curves, separately.
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