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Change in Grading of Stunting in Children aged 0-5 years in a Tertiary Hospital in Western India by Using WHO vs.

Anu Tresa1, Vaman Khadilkar2, Rahul Jahagirdar1

  • 1Department of Pediatrics, Bharati Vidyapeeth Medical College and Hospital, Dhankawadi, Pune, 411043, India.

Indian Journal of Pediatrics
|January 28, 2025
PubMed

Insights

The 2019 Indian synthetic growth charts identify fewer children with short stature compared to WHO charts. Using regional charts may prevent unnecessary investigations in apparently healthy children under five.

Area of Science:

  • Pediatric endocrinology
  • Growth monitoring
  • Public health

Background:

  • Accurate growth monitoring is crucial for identifying growth disorders in children.
  • Existing World Health Organization (WHO) growth charts may not accurately reflect the growth patterns of all populations.
  • Regional growth charts are being developed to better represent specific demographic groups.

Purpose of the Study:

  • To classify children under five into normal, short, severe short, and tall stature categories using WHO (2006) and Indian 2019 synthetic growth charts.
  • To compare the proportion of stunted children identified by these two sets of growth charts.
  • To evaluate the diagnostic implications of using different growth charts for short stature.

Main Methods:

  • A cohort of 1557 apparently healthy children aged 0-5 years was studied.
  • Children's stature was categorized using z-scores on both WHO 2006 and Indian 2019 synthetic growth charts.
  • Stature categories included severe short, short, normal, and tall.

Main Results:

  • The 2019 Indian synthetic charts classified a higher percentage of children as normal (85.4%) compared to WHO charts (73.5%).
  • The prevalence of short stature decreased from 15.03% on WHO charts to 7.77% on Indian charts.
  • Severe short stature prevalence dropped from 7.51% (WHO) to 2.38% (Indian charts).

Conclusions:

  • WHO growth charts may overdiagnose short stature in Indian children under five by 12.4%.
  • The use of the 2019 Indian synthetic growth charts resulted in a significantly lower prevalence of short and severe short stature.
  • Employing region-specific growth charts, like the Indian 2019 charts, can potentially reduce unnecessary medical investigations for children with normal growth patterns.
Abstract

Keywords:
2019 synthetic chartsChildrenGrowth chartStuntingUnder-five

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