Abstract
Introduction:Growth charts are widely used to assess children’s growth status and can provide a trajectory of growth during early important months of life. The objectives of this study are going to construct growth charts and normal values of weight-for-age for children aged 0 to 5 years using a powerful and applicable methodology. The results compare with the World Health Organization (WHO) references and semi-parametric LMS method of Cole and Green.Methods:A total of 70737 apparently healthy boys and girls aged 0 to 5 years were recruited in July 2004 for 20 days from those attending community clinics for routine health checks as a part of a national survey. Anthropometric measurements were done by trained health staff using WHO methodology. The nonparametric quantile regression method obtained by local constant kernel estimation of conditional quantiles curves using for estimation of curves and normal values.Results:The weight-for-age growth curves for boys and girls aged from 0 to 5 years were derived utilizing a population of children living in the northeast of Iran. The results were similar to the ones obtained by the semi-parametric LMS method in the same data. Among all age groups from 0 to 5 years, the median values of children’s weight living in the northeast of Iran were lower than the corresponding values in WHO reference data. The weight curves of boys were higher than those of girls in all age groups.Conclusion:The differences between growth patterns of children living in the northeast of Iran versus international ones necessitate using local and regional growth charts. International normal values may not properly recognize the populations at risk for growth problems in Iranian children. Quantile regression (QR) as a flexible method which doesn’t require restricted assumptions, proposed for estimation reference curves and normal values.
Highlights
Growth charts are widely used to assess children’s growth status and can provide a trajectory of growth during early important months of life
To provide a visual comparison of the semi-parametric LMS method of Cole and Green and nonparametric type of quantile regression (NQR) methods for estimating growth curves we present in Figure 3 the results for estimated 50 per cent growth curves using two methods for weight
It is observed that the quantile regression approach could detect and determined a suddenly weight loss at 24 months of infant age in girls this weight loss observed for boys at 30 months of ages (Figure 1 & 2) but it is not appear in World Health Organization (WHO) Curves (Figure 4)
Summary
Growth charts are widely used to assess children’s growth status and can provide a trajectory of growth during early important months of life. Results: The weight-for-age growth curves for boys and girls aged from to 5 years were derived utilizing a population of children living in the northeast of Iran. Reference curves and normal values are often required in medicine (Gannoun, 2002) These curves and values are used for assessment of the general nutritional status of populations of children in diverse settings, as an ancillary tool to screen children for health and nutrition disorders. They are a basis for educational materials that promote improved child care by families (Onis, Garza, & Habicht, 1997). There are several methods for obtaining these curves but the simple linear, systematic and efficient statistical methods for constructing them are lacking and these methods are not robust to outliers
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