Assessment Of Growth In Children Research Articles

Common problems in child growth assessment

儿童体格生长的监测和评价是儿科医生工作的重要内容。为便于儿科医生在工作中认识儿童生长规律，正确使用生长曲线，早期发现儿童生长偏离并及时干预，本文就相关问题进行讨论。.

Cross-sectional growth assessment of children in four refugee camps in Northern Greece.

Previous research has identified a high prevalence of growth abnormality among Syrian refugees in refugee camps in Jordan and Lebanon. There are few published data describing the growth status of children who are refugees in Europe. Refugees with up to 5 completed years of age in four refugee camps in Northern Greece were invited to participate in growth screening for clinical purposes. Mid-upper arm circumference (MUAC), weight for age (WFA), weight for height (WFH) and height for age (HFA) were measured. The World Health Organization (WHO) normal ranges and 'WHO Anthro' were used to calculate the prevalence of high WFH and low WFA, WFH, HFA, or MUAC. In total 177 (27% of children under 5 years in the four camps) were included. The male-to-female ratio was 1:1.04. Weight and height data were recorded for 114 children, and MUAC was recorded for 106 children. Two children (1.9%; 95% confidence interval [CI] 1.0-3.7%) had a MUAC more than 2 standard deviations (2SD) below the WHO mean value. Ninety-five percent were in the normal range for WFA. Four (3.7%; 95% CI 1.4-9.4%) were underweight (>2SD below the WHO median). Seventeen (16%; 95% CI 9.5-24.9%) had a high WFH, and 4 (3.7%; 95% CI 1.4-9.6%) were 2SD below the WHO median. Nineteen children (17.4%) had a low HFA, including 3 children under 1 year of age (13% of those under 1 year). Results demonstrated low prevalence of underweight for height, but high prevalence of stunting, suggesting chronic malnutrition. We recommend empirical micronutrient supplementation for children younger than 5 years and pregnant and breast-feeding women. Further research on the nutritional status of child refugees in camps in Greece is warranted to understand the cause of stunting and scope of any micronutrient deficiencies.

Avaliação do crescimento e desenvolvimento infantil na consulta de enfermagem

Objetivo: Analizar la evaluación del crecimiento y desarrollo infantil en la consulta de enfermería.Metodología: Estudio descriptivo con enfoque cualitativo. Los participantes del estudio fueron cuatro enfermeros que realizaban la consulta de enfermería a los niños de manera programática en unidades de salud de familia en Cuiabá, Mato Grosso, Brasil. La recolección de los datos se llevó a cabo mediante la observación participante de 21 consultas de enfermería entre enero y febrero de 2012. Los datos se analizaron con la técnica de análisis de contenido.Resultados: A partir del análisis de los datos, surgieron las siguientes dos categorías: Evaluación del crecimiento infantil en la consulta de enfermería y Evaluación del desarrollo infantil en la consulta de enfermería. Los enfermeros evaluaron el crecimiento infantil en todas las consultas, utilizando las curvas contenidas en la libreta personal de registro médico del niño. Sin embargo, el desarrollo infantil sólo fue evaluado parcialmente en la mayoría de las consultas observadas.Conclusión: Entre los aspectos más significativos de las consultas de enfermería se destacan la evaluación del crecimiento y desarrollo en todas ellas; y el uso de la libreta personal de registro médico del niño como instrumento de orientación para las madres y como estrategia de seguimiento del crecimiento y desarrollo infantil.

The Anthropometry in Nutritional and Growth Assessment of Children and Adolescents

The Anthropometry in Nutritional and Growth Assessment of Children and Adolescents

Courbes de l’indice de masse corporelle d’enfants et adolescents algériens (6–18 ans)

The body mass index (BMI) is widely accepted as a measure of overweight and obesity in children. There are no BMI reference charts for Algerian children and adolescents. The purpose of this study was to construct BMI percentile curves appropriate for children aged 6-18 years in Algeria. The weight and height of 7772 (54.9% girls) healthy schoolchildren from Constantine (eastern Algeria) were measured in 2008/2009. Weight and height for age curves based on the same sample were published previously. The BMI for age percentile curves were estimated in girls and boys separately using the LMS smoothing method. In both sexes, the median BMI increased with age. Girls had lower BMI values than boys before the age of 10 years but they were higher after this age until 18 years of age. Within the study population, the prevalence of overweight (including obesity) and obesity in girls and boys together was 13.7% and 3.0%, respectively, according to the International Obesity Task Force (IOTF) and 16.9% and 4.9% according to the World Health Organization (WHO) (2007). The median BMI curves of Algerian girls and boys were generally lower than those observed in other Arab countries. Compared with other references, the median BMI values of girls were lower than those of a Belgian Flemish population and WHO 2007 until 14 years of age and higher than the French reference between 7 and 18 years of age. The BMI values of Algerian boys were close to the Belgian (Flemish population), French and WHO 2007 references between 6 and 9 years of age and generally lower thereafter. These BMI curves are complementary to the height and weight charts published previously for the assessment of growth in children and adolescents. They were developed according to international guidelines and could serve as a national reference. They could be used as a complement to the 0- to 5-year-old WHO 2006 standards.

Knemometry Assessment of Short-Term Lower Leg Growth in Children with Asthma Treated with Inhaled Fluticasone Furoate

Knemometry Assessment of Short-Term Lower Leg Growth in Children with Asthma Treated with Inhaled Fluticasone Furoate

Practices of growth assessment in children: Is anthropometric measurement important?

Assessing and monitoring growth iscommon practice in pediatric care, andhealth professionals accept routine growthmonitoring in children as a standardcomponent of community child health servicesthroughout the world. In clinical level, by theseactivities one can detect and intervene while growthfaltering happens. The internationally recommendedway to assess malnutrition at population level is to takeanthropometric measurements. In developedcountries, growth monitoring is an intrinsic part of‘well child’ clinics. As growth is a proxy for childhealth, the child who grows well is generally healthyand illness in a child is usually associated with poorgrowth. Interpretation of child growth is based onanthropometric indicators established in a referencepopulation with cut-off points to differentiate under-and overnutrition, short stature or tall stature,proportionate or disproportionate growth. Practicesof growth monitoring consist of regularly measuringthe weight and height of children, then plotting theinformation on a growth chart to make abnormalgrowth visible. When growth is abnormal, the healthworker does something in concert with the family andas a result of these actions the child receivesappropriate social or medical support, his or hernutrition improves, or a serious condition is diagnosedearlier.

Electronic Health Record Mid-Parental Height Auto-Calculator for Growth Assessment in Primary Care.

Primary care providers are charged with distinguishing children with an underlying growth problem from those with healthy variant short stature. Knowing the heights of the biological parents aids in making that decision. This study sought to determine the feasibility and functionality of an electronic mid-parental height (MPH) auto-calculator in the clinical assessment of child growth in a pediatric primary care setting. Clinicians completed surveys for 62% of 6803 children (mean height 13 ± 7 percentile) with recorded parent heights. Collecting parent height data required <30 seconds in 91% of encounters. The MPH tool confirmed clinicians' initial growth assessment in 79% of cases and changed it in 4%; the remainder did not use the tool. Clinicians who changed assessment were more likely (P < .0001) to pursue more comprehensive evaluation. The MPH tool was a quick, functional resource as a component of an electronic health record system in actual, busy, pediatric primary care practices.

Relationship between stature and tibial length for children with moderate-to-severe cerebral palsy.

To derive the equation for estimating stature, based on tibial length, for children with moderate-to-severe cerebral palsy (CP) and lower limb joint contracture or scoliosis. The participants (3-12-years-old) included 50 children with moderate-to-severe CP (mean age, 8.3±2.4 years) and 38 typically developed (TD) children (mean age, 7.5±2.6 years). Thirty-four (68%) of the children with CP had a gross motor function classification system level of V. Furthermore, 40 (80%) had definite lower limb joint contracture or scoliosis. The stature and the tibial length measurements of all participants were determined. Regression equations to estimate stature, based on tibial lengths, were determined for both TD children and children with CP. Moreover, regression equations defining the relationship between tibial length and age were compared between the two groups of children, using multiple regression analysis. The regression equations for estimating stature, based on tibial length, were stature=tibial length×3.25+34.45 [cm], R(2)=0.91 (TD children), and stature=tibial length×3.42+31.82 [cm], R(2)=0.81 (CP children). In children with CP, tibial lengths were significantly shorter than those in similarly aged TD children. The stature of children with moderate-to-severe CP can be estimated from their tibial lengths, regardless of the presence of joint contracture or scoliosis. The tibial length may be a proxy for estimating stature during the growth assessment of children with moderate-to-severe CP.

Growth parameters among Saudi children attending the health care centre of King Faisal University, Al-Hassa, Saudi Arabia – is there deviation from normality?

Introduction: The assessment of growth in children is important for monitoring health status. Growth charts have been used for at least a century to screen for potentially inadequate growth. Objectives: To look at growth parameters of normal children at our university health centre. Material and methods: This is a prospective and descriptive study that was conducted in a primary health care centre of King Faisal University, Hofuf, Al-Hassa, Saudi Arabia. It is based on assessment of growth parameters, especially weight and height, of healthy children attending the health centre. Results: A total of 47 healthy children from birth to 11 years of age were included in this study. There were 25 males (mean age 3.1±2.5 years) and 22 females (mean age 4.8±3.6 years). The height parameter for most females was between the 25th and 75th percentiles. All male heights were above the 75th percentile. Regarding weight, males and females were equal between the 25th and 75th percentiles, but there was a linear growth pattern in weight parameter between the ages of 2 to 12 months in both males and females. Males had a tendency to be taller than females at all ages. Conclusions: Growth patterns over time using multiple data points must be used in conjunction with other medical and family history to evaluate appropriate growth. Training on accurate measurement techniques, especially for recumbent length, is critical for any assessment to be valid. Acknowledgements: Mentor Dr Gihan Yousef for mentoring this research.

Revised IAP growth charts for height, weight and body mass index for 5- to 18-year-old Indian children.

The need to revise Indian Academy of Pediatrics (IAP) growth charts for 5- to 18-year-old Indian children and adolescents was felt as India is in nutrition transition and previous IAP charts are based on data which are over two decades old. The Growth Chart Committee was formed by IAP in January 2014 to design revised growth charts. Consultative meeting was held in November 2014 in Mumbai. Studies performed on Indian children's growth, nutritional assessment and anthropometry from upper and middle socioeconomic classes in last decade were identified. Committee contacted 13 study groups; total number of children in the age group of 5 to 18 years were 87022 (54086 boys). Data from fourteen cities (Agartala, Ahmadabad, Chandigarh, Chennai, Delhi, Hyderabad, Kochi, Kolkata, Madurai, Mumbai, Mysore, Pune, Raipur and Surat) in India were collated. Data of children with weight for height Z scores >2 SD were removed from analyses. Data on 33148 children (18170 males, 14978 females) were used to construct growth charts using Cole's LMS method. To construct revised IAP growth charts for 5-18 year old Indian children based on collated national data from published studies performed on apparently healthy children and adolescents in the last 10 years. The IAP growth chart committee recommends these revised growth charts for height, weight and body mass index (BMI) for assessment of growth of 5-18 year old Indian children to replace the previous IAP charts; rest of the recommendations for monitoring height and weight remain as per the IAP guidelines published in 2007. To define overweight and obesity in children from 5-18 years of age, adult equivalent of 23 and 27 cut-offs presented in BMI charts may be used. IAP recommends use of WHO standards for growth assessment of children below 5 years of age.

Paediatric Growth Charts: How Do We Use Them and Can We Use Them Better?

Measurement of growth parameters is a key aspect of paediatric care.1 The admission of infants or children to a paediatric service provides an opportunity for the measurement of growth parameters. These measurements should then be reviewed and plotted correctly on standard growth charts,2 with intervention as indicated. We previously conducted a retrospective review of 103 consecutive admissions in our centre in November 2009 and elucidated the completeness of growth measurements and recordings in these children.3 Although almost all the children had measurement of their weight at admission, few had height and none had head circumference measured. In addition, growth charts were present and completed in a minority of the hospital records. Overall, this work demonstrated that opportunities were being missed to assess auxological parameters in children presenting to hospital acutely. Following the presentation of these outcomes to the department, new guidelines for the assessment of growth parameters at admission were instituted. These included a renewed emphasis on the importance of growth assessment, educational activities, reminders to measure and record growth and arrangements for a standardised location for the growth chart in paediatric medical notes. We have recently undertaken a further audit in November 2011. The notes of 100 consecutive admissions were reviewed, and the frequency of growth parameter documentation was assessed, following the previously described methodology.3 Weight was documented in 100% of the hospital notes of this group of children, whereas height was documented in 32%. Head circumference was documented in just 25% of the subset of children aged less than 2 years. Standard growth charts were present in the notes of 40% of children, and in 23% of cases the measured growth parameters were plotted on these charts, with no inappropriate plotting evident. Interestingly in 13% of cases either height, weight or both fell below the 3rd centile or above 97th centile for age. An appropriate management and follow-up plan was documented in the medical records of each of these children. These data demonstrate a moderate but encouraging improvement in the assessment and recording of growth in children presenting to this paediatric service. This change in practice was brought about by presentation of the issue to the department and highlighting the importance of growth assessment, prompting a change in guidelines for admitting doctors and nurses. Completion of an audit cycle along with ongoing educational activities will be important to further enhance the assessment of growth in children seen acutely in this centre. We remind practitioners of the importance of these core elements of paediatric practice.

550 Growth Assessment in Children after Acute Septic Versus Aseptic Menengitis: a Controlled Study

We recorded and analyzed the growth data of 40 children with acute meningitis (age 5.8 +/– 3.1 years) for a year or more after treatment and compared them with their...

Worldwide implementation of the WHO Child Growth Standards

To describe the worldwide implementation of the WHO Child Growth Standards ('WHO standards'). A questionnaire on the adoption of the WHO standards was sent to health authorities. The questions concerned anthropometric indicators adopted, newly introduced indicators, age range, use of sex-specific charts, previously used references, classification system, activities undertaken to roll out the standards and reasons for non-adoption. Worldwide. Two hundred and nineteen countries and territories. By April 2011, 125 countries had adopted the WHO standards, another twenty-five were considering their adoption and thirty had not adopted them. Preference for local references was the main reason for non-adoption. Weight-for-age was adopted almost universally, followed by length/height-for-age (104 countries) and weight-for-length/height (eighty-eight countries). Several countries (thirty-six) reported newly introducing BMI-for-age. Most countries opted for sex-specific charts and the Z-score classification. Many redesigned their child health records and updated recommendations on infant feeding, immunization and other health messages. About two-thirds reported incorporating the standards into pre-service training. Other activities ranged from incorporating the standards into computerized information systems, to providing supplies of anthropometric equipment and mobilizing resources for the standards' roll-out. Five years after their release, the WHO standards have been widely scrutinized and implemented. Countries have adopted and harmonized best practices in child growth assessment and established the breast-fed infant as the norm against which to assess compliance with children's right to achieve their full genetic growth potential.

Paediatric growth charts: How do we use them and can we use them better?

Measurement of growth parameters is a key aspect of paediatric care. The aim of this retrospective study was to ascertain rates of growth assessment in children in an acute paediatric setting and to define the frequency of placement of growth data on appropriate growth charts. The accuracy of plotting of growth data and role of potential factors were also examined. The charts of children attending the Children's Acute Assessment (CAA) unit at Christchurch Public Hospital, New Zealand, were reviewed. The frequency of documentation of height, weight and head circumference in the notes and on the appropriate growth chart was ascertained, along with review of the accuracy of the plotted data. Weight was documented in the charts of 95% and height in 5% of 103 children. None of the children had measurement of their head circumference. A growth chart was present in the notes of 27% of children, but just 7% of the group had a growth chart with the current measurements plotted. This study identifies a missed opportunity for assessment of the nutritional status of children in the hospital setting in New Zealand. The results highlight a need for optimising child growth assessment, particularly at a time of growing awareness of health inequalities and childhood obesity.

Bioarchaeological Evidence for the Basis of Small Adult Stature in Southern Africa

Natural selection for small adult body size may be directly linked to various factors that differ by global region. Indirect selection through early cessation of growth has been postulated for pygmy groups. Small adult body size was maintained throughout the Holocene by the ancestors of the KhoeSan groups, Later Stone Age hunter-gatherers who lived in the coastal and near-coastal regions of South Africa. Contextual information from 134 burials of juveniles (76 with radiocarbon dates) is combined with assessment of child growth. Both timing of cessation of growth and patterns of juvenile mortality are pertinent to questions about the possible selective value of smallness. Later Stone Age juveniles who had dental ages in the midteen years had not yet achieved adult size; hence, early cessation of growth is not evident. For the period between ca. 3800 and 1800 BP, which was a time of increased variability in adult body size, there are more burials of older juveniles. The variability in the mortality profile suggests fluctuations in the rates of juvenile mortality rather than consistently high rates. We conclude that small body size had been established by the Holocene, and we suggest that its maintenance is linked to direct rather than indirect selection.

Estudios españoles de crecimiento: situación actual, utilidad y recomendaciones de uso

The child growth assessment is useful not only for the follow up of children health but also for social purposes, as an indicator of the equity advances in the world. In Spain there has been a long tradition in carrying out growth studies. During the last decade five Spanish research groups have conducted studies among the population of Andalucía, Barcelona, Bilbao, Madrid and Zaragoza. They have combined their data and have produced the «Transversal Spanish Studies 2008 and 2010» and the «Longitudinal Spanish Study 1978/2000». These studies have showed that in Spain the regional differences on growth have disappeared, and that this has had a secular trend in the last decades. The Spanish adult height has approached to other European and American countries, still below some Centre and North European countries. There are some differences between the Spanish growth studies and the multicentric World Health Organization (WHO) growth study. This is due, among other reasons, to the different criteria that are used for the sample selection. In Spain the studies are based on the «population» criteria, whereas the WHO study is based on the «socioeconomic» and «nutritional» criteria. Currently for the Spanish population is appropriate to use, as standard reference, the Spanish multicentric studies, which are the transversal as well as the longitudinal studies. Due to the recent secular trend, it would be convenient to carry out, in the future, prospective transversal growth studies, methodologically homogeneous, representatives of the different Spanish regions, and preferably made every ten to fifteen years.

Measurement of Posttraumatic Growth in Young People: A Review

The potential of the positive psychology perspective to change the focus of clinical research and practice has become increasingly recognized. A variety of new psychometric instruments informed by positive psychology are now available to mental health clinicians, providing them with tools to assess change across the spectrum of human functioning. One area of research and practice in which this is evident is in posttrauma work, where it is becoming more common to assess posttraumatic growth alongside posttraumatic stress. The majority of work on posttraumatic growth has been with adults, but the last few years have also seen a new body of research with children and adolescents. The aim is to review literature relating to the measurement of growth. It is concluded that several measures with acceptable psychometric properties now exist for the assessment of posttraumatic growth in children and adolescents.

Non‐invasive longitudinal assessment of facial growth in children and adolescents with hypohidrotic ectodermal dysplasia

Facial growth patterns in 12 subjects (six boys and six girls) with hypohidrotic ectodermal dysplasia (HED) were analyzed and compared with facial growth patterns obtained in healthy reference peers. All subjects with HED were aged 7 yr (mean age +/- standard deviation: 7.08 +/- 0.41 yr) at the first examination and 14 yr (mean age +/- standard deviation: 14.56 +/- 0.34 yr) at the last examination. In each subject, the three-dimensional coordinates of facial landmarks were collected non-invasively at eight subsequent years. The volumes of forehead, nose, maxilla and mandible, upper lips, and lower lips were estimated. For each facial volume, differential values between different time points were calculated individually, separately for the 'childhood' (7-10 yr) and the 'adolescence' (11-14 yr) growth period in both HED and reference subjects. Children and adolescents with HED had a slightly reduced global facial growth in comparison with normal reference peers. The peak mandibular and maxillary development was delayed by approximately 2 yr towards later adolescence. The present non-invasive system seems to be useful for studying longitudinal changes of facial growth in healthy and syndromic subjects.

Continuous growth reference from 24th week of gestation to 24 months by gender.

BackgroundGrowth charts and child growth assessment have become prime global instruments in child health practice over the 30 years. An updated, continuous growth standard that bridges size at birth values with postnatal growth values can improve child growth screening and monitoring.MethodsThis novel growth chart was constructed from two sources of information. Size at birth (weight, length and head circumference) reference values were updated based on information of normal deliveries (i.e. singleton live births without severe congenital malformation, with healthy mothers and born vaginally) from the Swedish Medical Birth Registry, 1990–1999 (n = 810393). Weight was evaluated using logarithmic transformation as for postnatal weight. Standard deviations were estimated from data within the empirical mean ± 1.0 SD for each gestational week and gender. These values were smoothed by empirical curve-fitting together with values from our recently published postnatal growth reference including 3650 longitudinally followed children from birth to final height [9]. Timescale and weight axes were made logarithmic in order to magnify the early time part of the graph.ResultsThis study presents the first continuous gender specific growth chart from birth irrespective of gestational age at birth until 2 years of age for weight, length and head circumference. Birth weight at 40 weeks of gestation increased approximately 100 gram and length increased only 1 mm compared with earlier Swedish reference from 1977–81. The curve is now less S-shaped as compared with earlier curves and compared with 4 curves from other countries and with more constant variation over the whole range.ConclusionOur values picture the unrestricted pattern of growth improving the detection of a deviating growth pattern, when the growth of an individual infant is plotted on the charts. Especially for very preterm infants age corrected growth can be more easily evaluated although it must be recognized that the early comparison is with what is estimated as normal growth in uterus. The reference values are useful in child health care systems for population screening, but also in research or in the clinic for evaluating various growth promoting interventions – either nutritional, surgical or therapeutic – that might affect a child in early life.