Multicentre Growth Reference Study Research Articles

Growth charts for weight and height of Indian children with Down syndrome.

Age and gender specific growth charts for Indian children with Down syndrome (DS) based on longitudinal data have not been published. To establish percentile growth charts for DS children inhabiting northwestern parts of India, body weight and length/height of 1125 (Male: 752, Female: 373) children with DS aged <1 month to 10 years, enrolled from the "Genetics Clinic" were measured at half yearly age intervals in the "Growth Clinic" of the Institute from August 1994 to November 2018. A total of 2089 observations were made on these children using standardized anthropometric techniques and instruments following a prospective mixed-longitudinal growth research design. Using the LMS method, age and sex-specific percentile growth charts (<1 month to 10 years) for weight, and length/ height were generated. Unpaired t-test was used to compare mean growth attainments of study children with those of DS patients representing other population groups as well as their normal Multicentre Growth Reference Study (MGRS and Indian Academy of Pediatrics (IAP) counterparts. The 50th percentile growth curves for both weight and length/height of Indian children with DS demonstrated a regular increase. As compared to their normal MGRS and Indian (IAP) counterparts, the children with DS had lower weight and height attainments. The boys and girls with Down syndrome showed short stature (height < 3rd centile) from the age of 1 year till 10 years and also became underweight beyond 5 years. As compared to their normal counterparts, children with Down syndrome exhibited compromised auxological attainments. The use of growth charts presented herein may be used to compare and monitor growth and nutritional status of Indian children with Down syndrome.

Infant growth and body composition from birth to 24 months: are infants developing the same?

Given the importance of infancy for establishing growth trajectories, with later-life health consequences, we investigated longitudinal body composition among infants from six economically and ethnically diverse countries. We recruited mother-infant dyads using the WHO Multicenter Growth Reference Study criteria. We measured fat-free mass (FFM) in 1393 (49% female) infants from birth to 6 months of age (Australia, India, and South Africa; n = 468), 3-24 months of age (Brazil, Pakistan, South Africa, and Sri Lanka; n = 925), and derived fat mass (FM), fat mass index (FMI), and fat-free mass index (FFMI). Height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length (WHZ) Z-scores were computed. Sex differences were assessed using a t-test, and country differences using a one-way analysis of covariance. We further compared subsamples of children with average (-0.25 > HAZ < +0.25), below-average (≤-0.25) and above-average (≥+0.25) HAZ. HAZ performed well between 0 and 6 months, but less so between 3 and 24 months. The stunting prevalence peaked at 10.3% for boys and 7.8% for girls, at 24 months. By 24 months, girls had greater FMI (10%) than boys. There were significant differences in FFM (both sexes in all countries) and FM (Brazilian boys, Pakistani and South African girls) by 24 months of age between infants with average, above-average, and below-average HAZ. In a multi-country sample representing more ideal maternal conditions, body composition was heterogeneous even among infants who exhibited ideal length. Having a mean HAZ close to the median of the WHO standard for length reduced FFM between-country heterogeneity but not FM, suggesting that other factors may influence adiposity.

The Role of Nutritionist Personality in Efforts to Reduce Stunting at Mantrijeron Health Center, Yogyakarta City

Short toddlers are toddlers with nutritional status based on length or height for their age when compared to the WHO-MGRS (Multicentre Growth Reference Study) standard in 2005. Stunting is a condition of growth failure in infants (0-11 months) and children under five (12-59 months) due to malnutrition since the baby is in the womb and in the early period after the baby is born. Indonesia, especially Yogyakarta City, is an area affected by cases of short toddlers with poor nutritional status as many as 1225 cases where the Mantrijeron Health Center is the health center with the highest stunting cases in Yogyakarta City. Nutritionists are considered the frontline in terms of identifying public health and nutrition problems, especially in pregnant women and toddlers, which may trigger high stunting rates in Indonesia. The personality of the Nutritionist, seen from The Big Five Personality is considered capable of generating client interest in conducting regular consultations and being able to live a healthy life in the hope of suppressing the growth of stunting rates. The results of the study stated that the openness to experience dimension was absent in one of the Nutritionists as seen from the difficulty in adjusting the language and the obstruction of work due to lack of mastery of digital technology.

Biomass smoke exposure and somatic growth among children: The RESPIRE and CRECER prospective cohort studies in rural Guatemala

BackgroundCooking-related biomass smoke is a major source of household air pollution (HAP) and an important health hazard. Prior studies identified associations between HAP exposure and childhood stunting; less is known for underweight and wasting. Few studies had personal HAP measurements. Methods557 households in rural Guatemala were enrolled in the CRECER study, the follow-up study of the RESPIRE randomized intervention trial. They were assigned to three groups that received chimney stoves at different ages of the study children. Multiple personal carbon monoxide (CO) exposure measurements were used as proxies for HAP exposures. Children’s heights and weights were measured from 24 to 60 months of age. Height-for-age z-score (HAZ), weight-for-age z-score (WAZ), and weight-for-height z-score (WHZ) were calculated based on the World Health Organization’s Multicentre Growth Reference Study. HAZ, WAZ, and WHZ below −2 were classified as stunting, underweight, and wasting, respectively. Generalized linear models and mixed effects models were applied. Results541 children had valid anthropometric data, among whom 488 (90.2 %) were stunted, 192 (35.5 %) were underweight, and 2 (0.3 %) were wasted. A 1 ppm higher average CO exposure was associated with a 0.21 lower HAZ (95 % CI: 0.17–0.25), a 0.13 lower WAZ (95 % CI: 0.10–0.17) and a 0.06 lower WHZ (95 % CI: 0.02–0.10).The associations for HAZ were stronger among boys (coefficient = −0.29, 95 % CI: −0.35 – −0.22) than among girls (coefficient = −0.15, 95 % CI: −0.20 – −0.10). A 1 ppm-year higher cumulative CO exposure was associated with a higher risk of moderate stunting among boys (OR = 1.27, 95 % CI: 1.05-1.59), but not among girls. DiscussionIn this rural Guatemalan population, higher HAP exposure was associated with lower HAZ and WAZ. The associations between HAP and HAZ/stunting were stronger among boys. Reducing HAP might benefit childhood somatic growth in rural populations of low-income countries.

Comparing the accuracy of an ultrasound height measurement device with a wooden measurement board among children aged 2-5 years in rural Lao People's Democratic Republic: A methods-comparison study.

Height is a key component of nutrition assessments in children from limited-resource settings. This study aimed to assess whether handheld digital ultrasound devices for measuring children's height provide comparable accuracy to traditional measurement boards, which are bulky and difficult to transport. We trained 12 health workers to measure the standing height of 222 children aged 2-5 years in rural Lao People's Democratic Republic using both the ultrasound device and measurement board. The Bland-Altman method was used to depict limits of agreement and potential bias. We reported the technical error of measurement (TEM) for precision and accuracy, then assessed these results against the Standardized Monitoring and Assessment for Relief and Transition (SMART) Manual 2.0 and the WHO Multicentre Growth Reference Study (MGRS). The average difference between the ultrasound and board measurements was 0.096 cm (95% limits-of-agreement: 0.041cm, 0.61cm) with a systematic bias of 0.1cm (95% confidence interval: 0.067cm, 0.134cm), suggesting the ultrasound measurements were slightly higher than those from the board. The ultrasound and board TEMs for precision were 0.157cm and 0.091cm respectively. The accuracy TEM was 0.205cm. All TEMs were within SMART and WHO MGRS limits. The ultrasound device is comparable to the measurement board among standing Lao children aged 2-5 years for precision and accuracy TEMs but showed a bias of 0.1cm. Further studies are required to assess whether calibration can minimise this bias and determine the ultrasound's accuracy on recumbent length for infants and younger children.

Body composition from birth to 2 years.

Providing all infants with the best start to life is a universal but challenging goal for the global community. Historically, the size and shape of infants, quantified by anthropometry and commencing with birthweight, has been the common yardstick for physical growth and development. Anthropometry has long been considered a proxy for nutritional status during infancy when, under ideal circumstances, changes in size and shape are most rapid. Developed from data collected in the Multicentre Growth Reference Study (MGRS), WHO Child Growth Standards for healthy infants and children have been widely accepted and progressively adopted. In contrast, and somewhat surprisingly, much less is understood about the 'quality' of growth as reflected by body composition during infancy. Recent advances in body composition assessment, including the more widespread use of air displacement plethysmography (ADP) across the first months of life, have contributed to a progressive increase in our knowledge and understanding of growth and development. Along with stable isotope approaches, most commonly the deuterium dilution (DD) technique, the criterion measure of total body water (TBW), our ability to quantify lean and fat tissue using a two-compartment model, has been greatly enhanced. However, until now, global reference charts for the body composition of healthy infants have been lacking. This paper details some of the historical challenges associated with the assessment of body composition across the first two years of life, and references the logical next steps in growth assessments, including reference charts.

Re-defining stunting in Indonesia 2022: A comprehensive review

Stunting is a condition of failure to thrive in toddlers due to chronic malnutrition, especially in the first 1000 days of pregnancy, in rural families, there is no term-stunting even mothers with toddlers stunting have different meanings to the condition of toddlers stunting this is motivated by the meaning obtained from the stock of knowledge.Stunting itself is divided into 2 namely short toddlers(stunted) namely short and very short toddlers(severely stunted) namely toddlers with body length (PB/U) or height (TB/U) based on age with a comparison of WHO-MGRS standards (Multicentre Growth Reference Study) 2006. In this study uses the type or research literature approach to analys and described stunting in Indonesia. Conditions of stunting measured by height or body length that is minus two standard deviations of the median standard of toddler growth from WHO. The focus of this study is to look at the meaning of mothers with toddlers stunting and the actions of mothers with toddlers stunting. According to data from the Ministry of Health of the Republic of Indonesia, approximately 9 million toddlers experience it stunting with a prevalence of 37% in 2013. To the Ministry of Health's Basic Health Research in 2018, one of the factors for the high stunting seen directly is the low intake of nutrition and health. Decline stunting is considered important, therefore a multi-sectoral approach is planned through the synchronization of national, local, and community programs at the central and regional levels.

Factors Causing Stunting In Toddlers Aged 0 To 5 Years In Coastal Communities

In Indonesia, Stunting is a current issue with nutrition. About one in four children worldwide has stunted growth or stunting. When the nutritional status of a child is assessed using length, whether height and their z-score is below the WHO-MGRS (Multicentre Growth Reference Study) criteria in 2005, they are considered short toddlers. Children with z-score -3SD or lower are considered as very short toddlers. This study set out to identify the contributing causes to stunting in coastal areas. Quantitative research is the chosen research methodology. This type of study was conducted in the working space of Posyandu cadres in the village of Sialang Buah for the coastal area. It is a cross-sectional study that uses analytical methods. Based on that findings It might be argued that the findings of our coastal community, specifically that village by Sialang Buah, does not now have stunting but is susceptible to it. In Sialang Buah Village, toddlers are at risk for stunting because the mother's level of education is low, that parents' level on labor there is low, which results in less income.

Stunting prevention efforts in Siyangan Village, Tegalrejo District, Magelang

A child is considered stunted if, by the time they turn two years old, both his height and body length are below the WHO Multicentre Growth Reference Study standard. The aim of this PPMT activity is to increase public awareness and knowledge about stunting and improve food security. This program uses PRA, a strategy that includes socialization, training, and assistance with food security to improve the health of children with stunting. the general public's knowledge of stunting and efforts to prevent it has grown. By utilizing local resources, the team also hopes to assist the community increase its food security.

World variation in head circumference for children from birth to 5 years and a comparison with the WHO standards

ObjectiveA recent review reported that the WHO 2006 growth standards reflect a smaller head circumference at 24 months than seen in 18 countries. Whether this happens in early infancy and...

Newborn screening for spinal muscular atrophy in Australia: a non-randomised cohort study

In light of a new therapeutic era for spinal muscular atrophy (SMA), newborn screening has been proposed as a gateway to facilitate expedient diagnosis and access to therapeutics. However, there is paucity of evidence on health outcomes outside the homogenous populations in clinical trials to justify broader implementation of newborn screening for SMA. In this real-world study, we aimed to investigate the effectiveness of newborn screening coupled with access to disease-modifying therapeutics, as an intervention for SMA. In this prospective, non-randomised cohort study done at Sydney Children's Hospital Network (NSW, Australia), we included children younger than 16 years with homozygous exon 7 deletions of survival motor neuron 1 gene (SMN1) mutations, non-selectively assigned to a screening group (incident population diagnosed by newborn screening) from Aug 1, 2018, to Aug 1, 2020, or a comparator group (incident population diagnosed by clinical referral) from Aug 1, 2016, to July 31, 2018. We excluded infants with compound heterozygous SMN1 mutations and those participating in ongoing and unpublished clinical trials. Effectiveness of newborn screening for SMA was compared using motor development milestone attainment defined by WHO Multicentre Growth Reference Study at 2 years post diagnosis. Secondary outcome measures included mortality and change in Hammersmith Infant Neurological Examination-2 (HINE-2) score, ventilation requirements, and enteral requirements 2 years from the time of diagnosis. 34 children met the study inclusion criteria, but 33 children were included in the study population after one neonate was excluded due to participation in an ongoing unpublished clinical trial. 15 children were included in the screening group (seven [47%] male and eight [53%] female; median age 2·1 weeks [IQR 1·9-2·7]) and 18 children (nine [50%] male and nine [50%] female) were included in the comparator group (median age 47·8 weeks [13·0-99·9]). The 2-year survival rate was 93% (14 of 15 children) in the screening group and 89% (16 of 18) in the comparator group. Among survivors, 11 (79%) of 14 walked independently or with assistance in the screening group, compared with one (6%) of 16 children in the comparator group (χ2=16·27; p<0·0001). A significantly greater change in motor function was observed in the screening group compared with the comparator group over 2 years (HINE-2 score group difference, 12·32; p<0·0001). The requirement for non-intensive ventilation or feeding support at follow-up was higher in the comparator group than in the screening group (odds ratio 7·1 [95% CI 0·7-70·2]). Significant predictors of functional motor outcomes as determined by HINE-2 score at 2 years post diagnosis were HINE-2 score (p=0·0022), CHOP-INTEND (p=0·0001), compound muscle action potential (CMAP; p=0·0006), and disease status (p=0·023) at diagnosis. Newborn screening for SMA, coupled with early access to disease-modifying therapies, effectively ameliorates the functional burden and associated comorbidities for affected children. For children diagnosed through newborn screening, motor score, CMAP, and disease status at diagnosis has clinical utility to determine functional independence. Brain Foundation and National Health and Medical Research Council.

Weight-for-age z-scores of Japanese children using the World Health Organization Child Growth Standards.

Weight-for-age z-scores of Japanese children using the World Health Organization Child Growth Standards.

Comparison between the World Health Organization and Bahraini children growth standards

The aim of this study was to investigate the growth patterns of Bahraini female and male infants/young children aged 0-24 months in the Kingdom of Bahrain. A cross-sectional approach was employed to track the growth parameters among healthy Bahraini female and male infants/children aged 0-24 months. A multistage probability sampling criteria was used to collect information from official records. Anthropometric measurements (weight and length) and demographic characteristics on feeding practices were gathered. Generalized Additive Models for Location Scale and Shape (GAMLSS)/Lambda-Mu-Sigma methodology was implemented to select distribution type, optimize smoothing parameters, perform regression of growth models, and construct percentiles and Z-score charts and tables for weight for age, length for age, length for weight, and body mass index (BMI) for age. Findings were compared with WHO Multicentre Growth Reference Study (MGRS) data. A total of 403 healthy infants/children (210 males and 193 females) were recruited. At birth, the mean weight, length, and BMI were 3.2±0.4 kg, 3.1±0.4 kg, 49.7±2.3 cm, 48.8±2.1 cm, 13.2±1.6 kg/m2, and 12.8±1.5 kg/m2 for males and females, respectively. Anthropometrics of males were all statistically significantly higher than those of females at all age levels. The length and weight of the Bahraini infants/children were slightly higher than those of the WHO-MGRS. The outcomes of this study, presented as charts and tables, showed significant differences in comparison with the WHO-MGRS reference charts. Specifically, Bahraini children aged between 0 and 24 months of both sexes were taller and heavier than their cohorts in the MGRS reference charts. Further longitudinal studies are needed for monitoring the growth pattern of children using body composition methods, adiposity markers, and determinant factors of growth to investigate this deviation from the WHO-MGRS.

Factor associated with Stunting Incidents in Kepyar Village, Purwantoro District, Wonogiri Regency in 2021

Background: The WHO-MGRS (Multicenter Growth Reference Study) recommendations based on the height for age index define stunting as a condition in which the body is short or extremely short. The incidence of stunting among children under five is predicted to reach 21.9% in 2020 by the World Health Organization (WHO). Stunting affects 149.0 million children, who run the risk of developing stunted growth, poor brain development, lower IQ, and disease vulnerability. Objectives: The study aimed to find out the variables associated with the incidence of stunting in 2021 in Kepyar Village, Purwantoro District, Wonogiri Regency. Methods: The research design was case-control with a ratio of 1:1 consisting of 22 samples from cases and 22 samples from controls. 22 individuals who were not deemed to be at risk of suffering stunting made up the control sample for toddlers. Between November 2021 and January 2022, the study was carried out. Low birth weight (LBW), birth length, exclusive breastfeeding, mother's last educational level, mother's height, socioeconomic status, accessibility to weaning food, early breastfeeding initiation, and also considered the mother's age at conception were all independent variables. The dependent variable is stunting, which can be either chronic or mild to severe (-2 SD). Fisher's Exact Test was used to analyze this study. Results: The majority of children were not LBW (90.9%), followed by normal birth length (81.8%), exclusive breastfeeding (56.8%), low education level of the mother (72.7%), mother's height was not at risk (72.7%), early breastfeeding initiation (63.6%), low socioeconomic status (63.6%), proper weaning food (77.3%), and maternal age during pregnancy is not at risk (54.5%). Early initiation of breastfeeding and stunting incidents showed a statistically significant association (p-value of 0.005), then there was also a relationship between socioeconomic status and stunting incidents (p-value of 0.028). Conclusions: Socioeconomic status and early initiation of breastfeeding are associated with stunting incidents. To lower the frequency of stunting in Kepyar Village, early initiation of breastfeeding promotion needs to be optimized.

Is the World Health Organization’s multicentre child growth standard an appropriate growth reference for assessing optimal growth of South African mixed-ancestry children?

&#x0D; In South Africa (SA), it has been estimated that one-third of boys and 25% of girls under the age of 5 years are stunted, according to the World Health Organization (WHO) Multicentre Growth Reference Study. During the past decade, research in developed and developing countries has shown that the international growth standard overestimates stunting and/or wasting when compared with population-specific growth references. Population-specific growth references typically incorporate genetic and environmental factors and can therefore better inform public health by identifying children who may be at risk for malnutrition, or who may be ill. Using the universal growth standard in SA may not be accurately assessing growth. In this article, environmental and genetic factors, and their influence on growth, are reviewed. These points are illustrated through a brief history of the peopling of SA, with an understanding of the socioeconomic and political climate – past and present. We discuss the uniqueness of certain population groups in SA, with contributions regarding some of the shortest peoples in the world and a history of sociopolitical inequities, which may mean that children from certain population groups who are perfectly healthy would underperform using the universal growth standard. Therefore, we suggest that a local population-specific growth reference would serve to better inform public health policies, and address childhood health equity and physical developmental pathways to adult health risk status.&#x0D; &#x0D;

PEMBERDAYAAN MASYARAKAT DALAM PENCEGAHAN STUNTING DI DESA KOTO AGUNG KECAMATAN KELILING DANAU KABUPETEN KERINCI

Stunting is still a public health problem in developing countries such as Indonesia with a fairly high prevalence. Stunting is caused by lack of nutritional intake for a long time in the first 1000 days of life (HPK) which is a period of fulfilling nutrition for toddlers. The 2005 WHO-MGRS (Multicentre Growth Reference Study) standard showed that a z-score value less than -2SD was categorized as short, and categorized as very short if the z-score value was less than -3SD. It is known that they have not been widely exposed to stunting so that some of them think that their children / toddlers are shorter than their age is a genetic factor so they do not require further treatment. Koto Agung Village, is an area within the scope of the Jujun Health Center area. People in Koto Agung Village have varying ages ranging from infants and toddlers who are targeted in community service activities as well as throughout the life cycle who come from permanent residents of Koto Agung Village and migrants who live in Koto Agung Village, Keliling Danau District. The community or parents of babies and toddlers in Koto Agung Village mostly have upper secondary education, both mothers and fathers. The method of implementation in the community service program is through providing counseling about stunting to mothers in the Koto Agung Village area through 3 (three) stages, namely implementation strategy meetings, site surveys and preparation of facilities and infrastructure. The results of the implementation of Community Service activities are as follows: Most of the parents and community of Koto Agung Village have secondary education. Parents' knowledge about the stunting prevention program based on the results of the pre-test, most of the pregnant women did not know about the stunting prevention program, while based on the post-test results, almost all parents already understood the implementation of the stunting program

Growth and body composition trajectories in infants meeting the WHO growth standards study requirements.

While the World Health Organization (WHO) developed postnatal growth standards for infants, corresponding body composition data remains scarce. This study explores growth and body composition trajectories in infants meeting the WHO Multicentre Growth Reference Study (MGRS) eligibility criteria. Infants enrolled in this longitudinal cohort underwent anthropometric and body composition measurement by air displacement plethysmography (ADP) at 6 weeks, 12 weeks, and 5 months postnatally. Age and sex-specific growth and body composition percentiles were generated using GAMLSS, with extrapolated data at 5 months for those exceeding ADP weight limits. We evaluated which anthropometric measure (body mass index (BMI), weight for length or mid upper arm circumference) was most closely related to adiposity. Of the 225 infants with body composition measures, 187 met the WHO MGRS criteria. Their length and weight curves were comparable with WHO growth curves. Trajectory curves for fat and fat-free mass were developed. Of the anthropometric measures, BMI z score was most closely related to fat mass index z score at all timepoints. This study presents body composition trajectories for infants meeting the WHO growth standard criteria. BMI z score is the best anthropometric metric to estimate adiposity in infants. While postnatal growth standards derived from the WHO Multicentre Growth Reference Study (MGRS) exist for the routine clinical assessment of infant growth, this study fills the previous gap in the availability of corresponding body composition data for term-born, healthy, breastfed infants meeting the MGRS criteria. Extrapolation was used to obtain body composition values for infants exceeding the weight limit of the ADP device, to avoid construction of biased body composition curves. Sex-specific growth curves for fat mass, fat-free mass, fat mass index, and fat-free mass index are presented for a population meeting the World Health Organization growth standard criteria.

Pelatihan Metode Cilukba dalam Mencegah Kejadian Stunting pada Balita di Kelurahan Kalebajeng Kecamatan Bajeng Kabupaten Gowa

Stunting or short toddlers are toddlers with chronic nutritional problems, who have nutritional status based on length or height according to the age of toddlers when compared to the standard WHO-MGRS (Multicentre Growth Reference Study) in 2005, has a z-score value of less than -2SD and if the z-score value is less than -3SD categorized as toddler is very short. CILUKBA method training is a method to reduce the incidence of stunting. Cilukba method is kiss, hug and give this intake a method of combining parenting, parenting and nutrition to children. This training model is to train mothers who have children aged 0-5 years to be given knowledge of the right parenting patterns, namely giving kisses and hugs as a sign of affection and emotional closeness between mother and child, so that at the time of feeding the child is getting better, because the child feels comfortable and happy so that the child's growth and development becomes good. The problem faced by partners is cilukba method training has never been done in Kalebajeng Village so it needs to be given about knowledge how to provide parenting, nurturing and providing nutritious intake to toddlers so that their growth and development becomes good and can reduce stunting rates in Kalebajeng Village, Bajeng District, Gowa Regency. The activity will be held for 5 months with funding sources from the UMI Waqf Foundation. The output is in the form of publications in Mass Media (print / electronic), improving the understanding and skills of PKK, KADER and Dasawisma mothers in preventing stunting incidents in toddlers in Kalebajeng Village, Bajeng District, Gowa Regency.

Implementation of Motor Function Measure score percentile curves - Predicting motor function loss in Duchenne muscular dystrophy.

The Motor Function Measure is a standardized scoring system to evaluate motor function and monitor disease progression in neuromuscular diseases such as Duchenne muscular dystrophy. There are no available reference percentile curves for this measure. The aim of this analysis was to generate Motor Function Measure percentile curves for ambulant and non-ambulant patients affected by Duchenne Muscular Dystrophy, providing the opportunity to better evaluate the status and progression of an individual patient compared to other patients in the same age group. Data of patients aged between 6 and 15 years (819 measurements) was obtained from the international Motor Function Measure database. Age-dependent percentile curves were estimated using a "Generalized additive model for location, scale and shape" as suggested by the World Health Organisation Multicentre Growth Reference Study Group. Percentile curves for the Motor Function Measure total score and its sub-scores for patients with and without treatment with glucocorticoids are presented. Mean scores decline with age. Patients treated with glucocorticoids have higher mean values compared to glucocorticoid-naïve patients at the same age. The percentile curves with the online tool extend the clinical utility of the Motor Function Measure by facilitating the interpretation of individual standing and disease progression.

Anthropometric measurements of term babies delivered in a mission hospital in Southwest Nigeria.

Babies birth anthropometric measurements are useful for retrospective assessment of foetal in utero health status, anticipatory care and growth monitoring. At community level, measurements other than birth weight (BW) may help predict low BW (LBW). The aim of the study was to determine the mean anthropometric measurements of term babies, its comparability with standard values, acceptable cutoff and surrogate for LBW. A cross-sectional study involving 257 term babies delivered by booked mothers at the Sacred Heart Hospital Abeokuta and selected by systematic random sampling. BW, occipitofrontal circumference (OFC), chest circumference (CC), mid-upper arm circumference (MUAC) and crown-heel length (CHL) were measured, and data were analysed using SPSS version 21 with significant P < 0.05 and confident interval of 95%. Mean BW, CC, OFC, CHL and MUAC were 3.25 ± 0.47 kg, 33.32 ± 1.98 cm, 34.7 ± 1.93 cm, 48.16 ± 2.87 cm and 11.57 ± 1.41 cm, respectively, with no significant mean difference between male and female babies. The mean OFC was higher than the national standard, World Health Organization Multicentre Growth Reference Study (WHO-MGRS) and INTERGROWTH-21. The mean cutoff for LBW was OFC - 31.89 cm, CC - 29.56 cm, CHL- 43.33 cm and MUAC - 9.35 cm (P = 0.000) with OFC being the best surrogate of LBW at Sensitivity, Specificity and Degree of Accuracy/area under the curve of 66.7%, 97.6% and 82.1% respectively. LBW babies had lower mean anthropometric cutoff values at variance from the WHO-MGRS and INTERGROWTH-21. Mean OFC was higher than both standards reflecting the need for cautious interpretation to prevent misdiagnosis of macrocephaly. We recommend OFC as an alternative for predicting LBW when access to weighing scale is a challenge.