Growth Charts For Weight 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.

Modelling predictive gender- and gestation-specific weight reference centiles for preterm infants using a population-based cohort study

We aimed to model longitudinal data to create predictive growth charts for weight in preterm infants from birth till discharge, that took into account the differing growth rates post-birth when compared to in-utero growth and therefore was more representative of the data than the UK1990 reference charts. Data from birth until discharge (or death), was collected and rigorously cleaned for all infants born at <32 weeks of gestation over a 4-year period. Means and standard deviations from the UK1990 reference charts were used to compute standard deviation scores (SDS) for our cohort. 2/3rd of the data was randomly selected and used to create gestation and gender-specific predictive weight centile lines through novel application of mixed modelling methods. The remaining 1/3rd of the data was used to test model fit by comparing expected vs actual weights for the new model with those predicted by the UK1990 model. Data from 1,510 preterm infants was analysed. 1067 of these were used to produce the predictive model. Weekly SDS were significantly lower than predicted throughout hospital stay for all gestation groups when compared with UK1990 data. The test data (n = 539) fitted the new centile lines substantially better than those modelled by the UK1990 centile lines. Mixed modelling of longitudinal data produced new predictive references for weight centiles of preterm infants. A large population-based prospective study is needed to produce representative longitudinal reference growth charts using these methods.

Local growth charts for an Iranian child population aged 2\u20135 years in comparison with the World Health Organization Child Growth Standards

BackgroundThere are no national reference charts in Iran for children aged under five. This study aimed to develop representative growth reference charts of height, weight, and BMI for children aged 2–5 years in Isfahan, Iran, and to compare them with the WHO reference curves.ResultsThis population-based study has a combination of longitudinal and cross-sectional design. It included 1325 and 761 healthy children, who were born between 2002 and 2015 in Isfahan, central Iran, in longitudinal and cross-sectional phases. Expert health care providers measured the height and weight of children in health centers. The lambda-mu-sigma method was used to construct the age- and sex-specific growth charts of anthropometric measures. The study sample comprised 1029 boys and 1057 girls. The centiles of height, weight, and BMI of boys were higher than that of girls in all age groups. The weight patterns of studied children were close to those of the WHO references in the lower percentiles. However, our study children, especially girls, were lighter compared with WHO standards based on the middle and upper percentiles of the weight distribution. Compared with WHO standards, boys of our study were taller especially at older ages. The percentiles of the BMI for our study samples were considerably lower than WHO standards.ConclusionThere are differences between our local growth charts for weight, height, and BMI with WHO standards. The local growth standards could be more precise for assessing growth problems in local and national settings. Due to notable differences between our results with WHO standards, future studies are warranted for constructing nationwide growth charts.

A big-data approach to producing descriptive anthropometric references: a feasibility and validation study of paediatric growth charts

Both national and WHO growth charts have been found to be poorly calibrated with the physical growth of children in many countries. We aimed to generate new national growth charts for French children in the context of huge datasets of physical growth measurements routinely collected by office-based health practitioners. We recruited 32 randomly sampled primary care paediatricians and ten volunteer general practitioners from across the French metropolitan territory who used the same electronic medical records software, from which we extracted all physical growth data for the paediatric patients, with anonymisation. We included measurements from all children born from Jan 1, 1990, and aged 1 month to 18 years by Feb 8, 2018, with birthweight greater than 2500 g, to which an automated process of data cleaning developed to detect and delete measurement or transcription errors was applied. Growth charts for weight and height were derived by using generalised additive models for location, scale, and shape with the Box-Cox power exponential distribution. We compared the new charts to WHO growth charts and existing French national growth charts, and validated our charts using growth data from recent national cross-sectional surveys. After data cleaning, we included 1 458 468 height and 1 690 340 weight measurements from 238 102 children. When compared with the existing French national and WHO growth charts, all height SD and weight percentile curves for the new growth charts were distinctly above those for the existing French national growth charts, as early as age 1 month, with an average difference of -0·75 SD for height and -0·50 SD for weight for both sexes. Comparison with national cross-sectional surveys showed satisfactory calibration, with generally good fit for children aged 5-6 years and 10-11 years in height and weight and small differences at age 14-15 years. We successfully produced calibrated paediatric growth charts by using a novel big-data approach applied to data routinely collected in clinical practice that could be used in many fields other than anthropometry. The French Ministry of Health; Laboratoires Guigoz-General Pediatrics section of the French Society of Pediatrics-Pediatric Epidemiological Research Group; and the French Association for Ambulatory Pediatrics.

Morbidity profile and nutritional status of tribal under five children attending the phulwaris in rural Chhattisgarh

Background: According to UNICEF report, 19.8% children under-five years in India are wasted, 48% are stunted and 42.8% are underweight. Multisectoral initiatives by the national and state governments are yet to reduce the burden of malnutrition. Jan Swasthya Sahyog (JSS) Health Centre in Chhattisgarh, plays a vital role in improving nutritional status of tribal under- three children attending the phulwaris (or creches). Objectives of this study were to assess the nutritional status of under-five children attending the phulwaris located under Bamhni sub center and to identify the common morbidities among these children.Methods: The researchers conducted health check-up for 357 children in the 19 phulwaris of Bamhni sub center spread over 16 villages.Results: Mean age of children attending the phulwaris was found to be 29±12.5 months. Among the 357 children, 128 (35.9%) were underweight; 53 (14.8%) were severely underweight; 35 (9.8%) were wasted; 18 (5%) were severely wasted; 58 (16.2%) stunted and 16 (4.5%) severely stunted according to WHO growth charts for weight for age, weight for height and height for age respectively. Point prevalence of morbidity was 142 (39.7%), which included respiratory tract infection (24.6%); scabies (8.4%); otitis media (3.1%); pyoderma (2.2%); developmental delay (2.2%); worm infestation (2.2%); sickle cell anemia (0.6%) and (0.3%) had epilepsy.Conclusions: Under nutrition was still prevalent among the children attending the phulwaris and upper respiratory tract infection was the most common morbidity.

Standard Growth Charts for Weight of Children in East Java Using Local Linear Estimator

Health Card that is in Indonesia called as Kartu Menuju Sehat (KMS) is used to asses nutritional status of children up to five years old. The anthropometric index recorded in the Health Card is weight for age. The goal of this paper is to design standard growth charts for both boy and girl of weight for age of children in East Java, Indonesia. These growth charts are used to assess nutritional status of children in East Java, Indonesia. The rate of growth of weight is not the same for every interval of ages. For this case, the using of local linear estimator is suitable to design standard growth charts of weight for age of children up to five years old. The results show that the average values of R-square are 99.72% for boy and 99.73% for girl. Also, the average values of mean square error are 0.02758 for boy and 0.02976 for girl. In addition, the standard growth charts for both boy and girl of weight for age of children up to five years old in East Java, Indonesia is lower than those of WHO-2005 standard charts.

PO-0382 Developmental Delay In Trisomy 21 Children From Romania

Aims Trisomy 21 is the most frequent autosomal chromosomopathy. The developmental delay is a constant finding. This study aimed to evaluate the auxological parameters of Romanian trisomy 21 patients and to correlate them with the cytogenetic findings. Material and method We conducted an observational study on 136 patients with cytogenetically confirmed trisomy 21 that were evaluated recording their auxological parameters. The nutritional status of the patients was evaluated using growth charts from WHO until 5 years and from CDC over 5 years. For infants, the ponderal index was used. For patients ≥1 year, we used growth charts for weight and BMI and standard deviation score for height. The growth parameters were statistically evaluated considering three age groups (newborn, infant, child ≥1 year) and the cytogenetic anomalies. Results 91.2% of patients had regular trisomy 21. The mean birth weight was 2904grams and the mean birth length 49,6cm. 80% of the infants associated protein-caloric malnutrition; the length was affected in 54.9% of 1 month - 1 year patients. 49.4% of patients ≥1 year were underweight, 37.03% were overweight and 75.3% associated short-stature. Only 14.5% of patients Conclusions The somatic delay varied in relation to age. In infants underweight dominated. In children ≥1 year short-stature was the main finding and one third of patients were overweight. Only a reduced number of trisomy 21 children had normal auxological parameters.

Toward body composition reference data for infants, children, and adolescents.

Growth charts for weight and height have provided the basis for assessment of children’s nutritional status for over half a century, with charts for body mass index (BMI) introduced in the 1990s. However, BMI does not provide information on the proportions of fat and lean mass; and within the past decade, growth charts for children’s body composition have been produced by using techniques such as skinfold thicknesses, body circumferences, bioelectrical impedance analysis (BIA), and dual-energy X-ray absorptiometry (DXA). For public health research, BIA and skinfold thicknesses show negligible average bias but have wider limits of agreement than specialized techniques. For patients, DXA is the best individual method, but multicomponent models remain ideal because they address perturbations in lean mass composition. Data can be expressed in age- and sex-specific SD scores, in some cases adjusting for height. Most such reference data derive from high-income countries, but techniques such as air-displacement plethysmography allow infant body composition growth charts to be developed in low- and middle-income settings, where the data may improve understanding of the effects of low birth weight, wasting, and stunting on body composition. Recent studies suggest that between-population variability in body composition may derive in part from genetic factors, suggesting a universal human body composition reference may not be viable. Body composition growth charts may be extended into adult life to evaluate changes in fat and lean mass through the entire life course. These reference data will improve the understanding of the association between growth, body composition, health, and disease.

Describing the growth and rapid weight gain of urban Australian Aboriginal infants

The aims of this paper are to describe the growth of urban Australian Aboriginal infants from birth to 24 months of age and to identify the proportion of these infants experiencing rapid weight gain (RWG) and overweight/obesity. The Gudaga Study is a longitudinal birth cohort of 159 Australian Aboriginal children born on the urban fringe of Sydney. Birthweight and length were extracted from hospital data. Children with a birthweight >1500 grams were included in the analysis (n = 157). Weight, length and head circumference were measured at 2-3 weeks and then six-monthly until 24 months of age. Age- and gender-specific Z-scores were determined from the Centers for Disease Control (CDC) 2000 growth charts for weight, length, head circumference and body mass index (BMI). The proportion of children experiencing RWG (an increase in weight-for-age Z-scores ≥0.67 between birth and 12 months) was calculated. The association between RWG and ≥85th CDC percentile for BMI at 24 months was tested using Pearson's χ². The mean weight of Gudaga infants was less than the CDC mean length-for-age at birth and 2-3 weeks of age but greater than CDC mean length-for-age and weight-for-age at 18 and 24 months of age. Overall, 42 infants (34.4%) experienced RWG, and 45 infants (36.9%) were overweight/obese at 24 months of age. A greater proportion of those who experienced RWG (61.9%) were overweight/obese at 24 months than those who did not experience RWG (23.8%). Our study suggests a concerning proportion of urban Indigenous infants experience RWG and overweight/obesity in early childhood.

Growth charts of Down syndrome in Egypt: A study of 434 children 0–36 months of age

The aim of the study was to construct new reference growth charts for weight, length and head circumference of Egyptian children with Down syndrome (DS) from birth to 36 months of age. These specific charts may be used by health professionals involved in medical, physical and developmental care of Egyptian children with Down syndrome. The study included 434 children with non-disjunction trisomy 21, 0-36 months of age. They were 54.4% males and 45.6% females and had no concomitant chronic disease (congenital heart disease, gastrointestinal malformations, hypothyroidism, and blood disorders). Overall, 1,955 observations were performed of weight, length and head circumference. The data for each sex were divided into 37 different age groups with 1-month intervals. All measurements were taken using standardized equipments and following the international recommendations. Values were statistically analyzed and growth curves were plotted as means and standard deviations (SD). Growth measurements evaluated in all age groups of both sexes were significantly lower than those of the controls. There was a gender difference in weight, length and head circumference, males with Down syndrome had higher values. In conclusion, we suggest that these new growth charts specific for Down syndrome children may be used in optimizing direct Egyptian DS children care and in providing anticipatory guidance in term of optimal physical growth and early detection of hidden factors affecting growth.

Weight Growth Charts from Birth to 6 Years of Age in Japanese Triplets

We analyzed the characteristics of weight growth and present the weight growth charts from birth to 6 years of age in Japanese triplets. The study included 366 mothers and their 1098 triplet children, who were born between 1978 and 2006. Data were collected through a mailed questionnaire sent to the mothers asking for information recorded in medical records. For these births, data on triplets' weight growth, gestational age, sex, parity, and maternal age at delivery were obtained from records in the Maternal and Child Health Handbooks, which is provided by the authorities after a report of pregnancy. Birthweight proved to be the strongest contribution on weight of triplets from 1 to 6 years of age. In addition, gestational age was also a significant contributing factor to weight from birth to 6 years of age. Moreover, males had a higher weight from birth to 6 years of age than females. Compared to the 50th percentile of the growth standard for the general population of Japan, the weight deficit of the triplets was more than 40% at birth (male, -1.28 kg; female, -1.28 kg), decreased within the first 1 year of age, and fluctuated between 4% and 9% until 6 years of age (male, -1.82 kg; female, -1.78 kg). In conclusion, triplets have lower birth weight than singletons and in spite of the rapid catch-up growth during first year of life they are behind singletons even in mid-childhood. This study provides growth curves for use in triplets.

Growth of Very Low Birth Weight Infants at 12 Months Corrected Age in Southern Brazil

The objective of this article is to describe growth of very low birth weight infants born in southern Brazil. All infants weighing < or =1500 g were followed up until 12 months corrected age (CA). Growth was recorded at 40 weeks, 6 and 12 months CA. Catch up was considered if the measures were > or =-2 SD of World Health Organization growth charts for weight and length; and of National Center for Health Statistics for head circumference. One hundred and ninety three infants born were followed up for the study. At 40 weeks CA, 57.8% patients achieved catch-up in weight and 50.9% in length. At 6 months CA, 82.2% achieved catch-up for weight and length and at 1 year CA, 92% achieved catch-up in weight and 86.9% in length. Catch-up in head circumference was achieved for 93.4%, 85.9% and 85% patients at 40 weeks, 6 months and 12 months CA, respectively. At 12 months CA, no catch-up in weight, length and head circumference was related to higher SNAPPE-II (P = 0.046) and periventricular leukomalacia (PVL) (P = 0.003); longer time to achieve full enteral nutrition at the neonatal intensive care unit (NICU) (P = 0.037), lower maternal education (P = 0.018) and PVL (P = 0,003); higher SNAPPE-II (P = 0,004), PVL (P = 0.005) and longer time to achieve full enteral nutrition at the NICU (P = 0.044), respectively. In conclusion, PVL and higher SNAPPE-II were important factors to catch-up delay. Catch-up growth was high at 12 months CA.

Body mass index reference values (mean and SD) for Swedish children

Body mass index (BMI) is an important indicator of nutritional status. Many studies have been done to present BMI reference values in centile values rather than mean and SD values since its statistical distribution is positively skewed. Both height and weight growth charts are usually available in terms of mean and 1, 2 and 3 SD around the means; it would be of clinical value to produce BMI reference charts in a similar way. The aim of this work was to derive the mean and ±1, 2 and 3 SD BMI reference ranges as a supplement to the BMI centile reference values published previously for the same group of Swedish children. The method was based on an age‐dependent Box transformation, and the β‐value was given as a third‐degree polynomial function over the paediatric age. The BMI reference values can be given from mathematical functions in addition to values for specific ages. Conclusion: The BMI reference values and charts derived as described effectively reflect the nature of the variant age‐dependent positive skewed statistical distribution of BMI values in the population, and can serve as a valid supplementary tool in the evaluation of growth and nutrition during paediatric years.

Body mass index reference values (mean and SD) for Swedish children.

Body mass index (BMI) is an important indicator of nutritional status. Many studies have been done to present BMI reference values in centile values rather than mean and SD values since its statistical distribution is positively skewed. Both height and weight growth charts are usually available in terms of mean and 1, 2 and 3 SD around the means; it would be of clinical value to produce BMI reference charts in a similar way. The aim of this work was to derive the mean and +/- 1, 2 and 3 SD BMI reference ranges as a supplement to the BMI centile reference values published previously for the same group of Swedish children. The method was based on an age-dependent Box transformation, and the beta-value was given as a third-degree polynomial function over the paediatric age. The BMI reference values can be given from mathematical functions in addition to values for specific ages. The BMI reference values and charts derived as described effectively reflect the nature of the variant age-dependent positive skewed statistical distribution of BMI values in the population, and can serve as a valid supplementary tool in the evaluation of growth and nutrition during paediatric years.

P119 Construction of height and weight growth charts for iran from hierarchically structured data; With an investigation of appropriate statistical methods

In the last 30 years we have seen considerable progress in the management of patients with diabetes, in particular with diabetic renal disease. A number of paradigms have been broken down, namely the following, as a consequence, clinical care has improved dramatically.1.Significant renal involvement and albuminuria is rare in patients with essential hypertension.2.High GFR is good for prognosis.3.Only proteinuric diabetic patients have a poor prognosis.4.Microalbuminuria only predicts renal disease.5.Reducing blood pressure may cause low perfusion in the kidney and other organs with long-term negative effect, especially on the glomerular filtration rate.6.Only in the presence of high blood pressure, should microalbuminuric patients receive anti-hypertensive treatment, including blockade of the RAS.7.Only reducing blood pressure by blocking RAS in diabetes is relevant and justified.8.Normoalbuminuria as indicated in the present definition is ‘normal’.9.ACE-I or ARB can only be used separately.10.Diastolic blood pressure and later systolic pulse pressure are the best parameters for blood pressure recording.11.Microalbuminuria is the strongest risk marker in patients with type 1 diabetes.12.Screening for microalbuminuria is relevant, but follow-up was not proposed (also regarding microalbuminuria).In the present situation, it is well-known that patients with essential hypertension may sometimes have microalbuminuria, and it is known that it predicts a poor prognosis. Interestingly, in type 1 diabetes, hyperfiltration is a marker for poor prognosis related to metabolic control. Thus hyperfiltration is a marker for bad development, but microalbuminuria (below the proteinuric level) is also associated with a poor prognosis.It was originally believed that microalbuminuria only predicts renal disease. However, surprisingly it predicts as well cardiovascular disease and early mortality. The story about blood pressure and progression of renal disease is interesting, because it was earlier believed that a certain high blood pressure was mandatory for preservation of the renal function. This appeared to be a completely wrong concept.The data regarding microalbuminuria suggest that patients with microalbuminuria should receive anti-hypertensive treatment, even patients with so-called normal blood pressure. This was confirmed in several trials and also included in the guidelines. Reducing blood pressure is important, but it appeared to be especially beneficial to block the renin–angiontensin system, and it is clear that albuminuria is a continuous variable and is also a risk factor. Earlier it was suggested to use ACE-inhibitors or ARBs. Now it is clear that it is possible to use a combination, with good theoretical background.In the history of hypertension, it was earlier believed that diastolic blood pressure was most important, but later on it was generally accepted that systolic is a better predictor and the goal for treatment and pulse pressure may be even better.Not only is microalbuminuria an important risk marker, but it is as well clear that regression of microalbuminuria is a good marker for a better prognosis in patients. Microalbuminuria is believed to be the strongest risk factor, but new studies actually suggest that a simple parameter such as self-rated health is crucial along with other factors.Regarding new developments, it is clear that new studies have led to several advancements in management in patients, for instance the Steno II study shows positive effect on mortality by multifactorial intervention. Similarly, the ADVANCE study also showed positive effect on mortality by more intensified anti-hypertensive treatment with an ACE-inhibitor. We are eagerly awaiting the results from glucose arm in the ADVANCE study, especially in the light of the ACCORD study showing increased mortality with too strict glycemic control with a goal of 6% in HbA1c.

Do growth chart centiles need a face lift?

European height and weight growth charts commonly extend from the 3rd to the 97th centile, whereas in North America the extremes are usually the 5th and 95th centiles. There is no good reason for the difference, and neither chart is particularly useful for screening owing to the high false positive rate associated with a cut off based on the lowest centile. The World Health Organisation's international growth reference uses cut offs based on standard deviation scores rather than centiles, which are more suitable for the extremes of growth status seen in the developing world. This chart, however, is incompatible with charts based on centiles. Here a unified growth chart is proposed: it has nine rather than seven centiles, and they are spaced two thirds of a standard deviation score apart rather than the more usual unit spacing. This gives a set of curves very like the conventional 3rd to 97th centiles, but with additional curves at 2.67 standard deviation below and above the mean (roughly the 0.4th and 99.6th centiles). The 0.4th centile is a more practical cut off for screening purposes than the 3rd or 5th centile.

Weight‐for‐height standards in adulthood

Although there are some Swedish studies giving reference values for height and weight in adulthood, no values of weight for height (W/H) are available. W/H is an essential measurement, as it permits comparison of weight independent of the height of an individual. We here present a method of constructing W/H standards, illustrated by a material sample of 4438 healthy individuals, 20-80 years of age, living in the Uppsala County during the period 1964-1971. In setting standards of W/H, the 'normal' increase in weight during adulthood and the distribution skewness of weight are both shown to be important. This weight gain starts at about 40 years of age, and is completed at approximately 55 years of age. It can be regarded as a 'normal' pattern, but not necessarily the optimum healthy one. Using ordinary growth charts for weight and height, a simple means of expressing W/H in standard deviation scores is outlined. It is difficult to find a representative Swedish sample, owing to geographical and psychosocial differences, and also to the secular trend phenomenon. However, the mean values for weight and height obtained in the present study fall between the mean values of two other recently conducted Swedish studies.