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New growth charts for children and adolescents in Catalonia, Spain: developed from routinely collected data

Núria Mora1, Anna Palomar-Cros2, Laura Pérez-Crespo2

  • 1Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes 587, Barcelona, Spain.

BMC Public Health
|April 11, 2026
PubMed

Insights

New growth charts for children in Catalonia, Spain, were developed using electronic health records. These region-specific charts, including weight and BMI, are higher in top percentiles than WHO standards, aiding early health condition detection.

Area of Science:

  • Pediatrics
  • Public Health
  • Biostatistics

Background:

  • Growth charts are critical for monitoring child development and identifying health issues early.
  • Existing growth charts may not accurately reflect current population-specific growth patterns.
  • Real-world data from electronic health records (EHR) offer a valuable resource for updating growth references.

Purpose of the Study:

  • To develop updated, region-specific growth charts for children and adolescents in Catalonia, Spain.
  • To utilize a large dataset from primary care EHR to create accurate anthropometric references.
  • To provide healthcare professionals with a reliable tool for growth assessment in the local population.

Main Methods:

  • Utilized routinely collected EHR data from Institut Català de la Salut (2013-2019).
  • Included children aged 1 month to 14 years with birthweight >2500g and at least one anthropometric measurement.
  • Employed Generalized Additive Models for Location, Scale and Shape (GAMLSS) to fit growth references for head circumference, weight, length/height, and BMI.

Main Results:

  • Generated new growth charts based on 876,097 records from 155,950 children.
  • New charts showed higher percentiles for weight and BMI (from age 4) compared to WHO standards.
  • Validation confirmed chart accuracy, with minor differences in extreme percentiles for weight and BMI at older ages.

Conclusions:

  • Successfully created novel, region-specific growth charts for Catalonia's pediatric population.
  • The new charts accurately represent local growth patterns, offering an improvement over existing references.
  • These charts serve as an essential tool for primary care professionals in Catalonia for growth monitoring.
Abstract

Keywords:
ChildhoodElectronic health recordsGrowth curvesPrimary care

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