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Growth of Chicago-area infants, 1985 through 1987. Not what the reference curves predict. Pediatric Practice Research
H J Binns1, Y D Senturia, S LeBailly
1Department of Pediatrics, Children's Memorial Hospital, Northwestern University, Chicago, III, USA.
Insights
The National Center for Health Statistics (NCHS) growth curves do not accurately reflect current infant growth. New, nationally representative data are needed to update these important pediatric growth references.
Area of Science:
- Pediatric Growth and Development
- Public Health Surveillance
Background:
- The National Center for Health Statistics (NCHS) provides growth curves used to assess infant development.
- Previous NCHS growth curves were based on data from white infants born between 1929 and 1975.
Purpose of the Study:
- To evaluate whether the NCHS growth curves accurately represent contemporary infant growth patterns observed in pediatric practices.
- To compare infant growth metrics against established NCHS references.
Main Methods:
- An observational cohort study involved 1574 healthy infants from ten pediatric community practices.
- Standardized measurements were collected at health maintenance visits from 2 to 54 weeks of age.
- Sex-specific growth curves were generated using a 3-parameter mathematical model and compared to NCHS references.
Main Results:
- Infants in the study cohort exhibited significantly greater mean birth weights compared to the NCHS cohort.
- PPRG infants were heavier at 1, 3, and 6 months, longer across all measured intervals, and had larger head circumferences than indicated by NCHS curves, especially in early infancy.
Conclusions:
- The current NCHS growth curves do not adequately reflect the growth patterns of contemporary infants.
- There is a critical need for updated, nationally representative data to revise and improve the accuracy of NCHS growth curves for modern pediatric care.
Objective:
To determine if the National Center for Health Statistics (NCHS) growth curves (including 867 white infants, born between 1929 and 1975, in the Yellow Springs, Ohio, area) reflect contemporary infant growth in pediatric practices.
Design:
Observational cohort study of healthy term infants. Office personnel obtained standardized measurements at health maintenance visits.
Setting:
Ten pediatric community practices that were members of the Chicago, III, area Pediatric Practice Research Group (PPRG).
Methods:
Measurements of 1574 PPRG infants, seen on at least 5 occasions between 2 and 54 weeks of age, generated sex-specific growth curves using a 3-parameter mathematical model fitted to the serial data for each infant. Values from the computed curves were compared with NCHS growth references at 1, 3, 6, 9, and 12 months. The birth weights of PPRG and NCHS cohorts were compared.
Results:
Mean birth weight of PPRG infants was significantly greater than a similar NCHS measure. Compared with the NCHS reference curve, PPRG infants were heavier at 1, 3, and 6 months, longer on all comparisons, and had greater head circumferences, particularly in the early months of age.
Conclusions:
The NCHS growth curves do not accurately reflect infant growth in this cohort. Nationally representative data are needed to revise the NCHS growth curves.