Implementation of new indicators of pediatric malnutrition and comparison to previous indicators
Mai Adnan Ezzat1, Ebtsam Mohmmed Albassam1, Eman Abdullah Aldajani1
1Department of Nutrition, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Insights
New Z-score indicators identified more cases of pediatric malnutrition than traditional growth charts. Early detection using Z-scores is crucial for timely intervention and improved child health outcomes.
Area of Science:
- Pediatric Nutrition
- Growth Monitoring
- Public Health
Background:
- Early identification of childhood malnutrition is critical for improving health outcomes.
- Timely intervention for pediatric malnutrition reduces the risk of long-term complications.
- Accurate assessment tools are essential for effective malnutrition management.
Purpose of the Study:
- To evaluate new Z-score malnutrition indicators for pediatric malnutrition detection.
- To compare the accuracy of Z-scores with traditional growth chart centiles.
- To assess the ability of Z-scores to identify degrees of malnutrition severity.
Main Methods:
- Retrospective study of 475 pediatric patients over six months.
- Collected weight, height, and age data.
- Compared malnutrition assessment using traditional growth charts (centiles) and updated Z-score indicators.
Main Results:
- Z-scores identified a higher percentage of malnutrition: 4.7% more for weight-for-length in <2 years, and 9.6-15.8% more for BMI-for-age in >2 years.
- Significant differences were found in classifying children as normal vs. malnourished using Z-scores compared to centiles (P<.0001).
- Approximately 34% of children deemed normal by centiles were classified as malnourished by Z-scores, with shifts in severity classification.
Conclusions:
- Z-score indicators (BMI-for-age and weight-for-length) identified a greater proportion of malnourished children compared to centile growth charts.
- The study highlights the increased sensitivity of Z-scores in detecting pediatric malnutrition.
- Utilizing Z-scores may lead to earlier and more comprehensive identification of malnutrition in children.
Background:
Early identification of childhood malnutrition is imperative to improve overall health outcomes, and more importantly, to start early intervention to decrease the risk of future complications. This study aimed to evaluate new malnutrition Z-score growth indicators for detecting pediatric malnutrition and degrees of severity and compare their accuracy with that of growth chart centiles.
Patients And Methods:
This retrospective study included 475 pediatric patients from several pediatric nutrition clinics for six months. The participant's weight, height, age, and growth parameters were recorded using both traditional growth charts (centiles) and updated malnutrition indicators (z-scores). The percentage and degree of malnutrition using centiles and Z-scores were compared.
Results:
In children aged <2 years, the percentage of malnutrition was 4.7% higher when measured using new malnutrition indicators (weight-for-length Z-score) compared with (weight-for-length centiles). Our results also showed 9.6% higher number of malnourished children >2 years of age when BMI-for-age Z-score was used compared to weight-for-height centiles while there were 15.8% higher malnourished children when BMI-for-age Z-score was compared to BMI-for-age centiles for the same group. We found a significant difference (X2 = 202.548, P=<.0001) between the degree of malnutrition in children aged >2 years using BMI-for-age Z-score (normal vs. malnourished) and the degree of malnutrition using BMI centiles (normal vs. malnourished). Approximately 34% of the children classified as normal using centiles were classified as malnourished using Z-scores. Comparing the degrees of Malnutrition, approximately 23% (45 of 196) of children classified as normal based on centiles were classified as having mild malnutrition when Z-scores were used, and 42% (80 of 192) of children who were classified as having mild malnutrition based on centiles were classified as having moderate malnutrition when Z-scores were used.
Conclusions:
In our study, a higher percentage of children showed malnutrition when assessed using the Z-score (BMI-for-age for children >2 years/weight-for-length for children <2 years of age) than the centiles growth chart.
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