Growth of Belgian and Norwegian children compared to the WHO growth standards: Prevalence below -2 SD and above +2 SD and the effect of breastfeeding

ArticleinArchives of Disease in Childhood 96(10):916-21 · November 2009with21 Reads
Impact Factor: 2.90 · DOI: 10.1136/adc.2009.166157 · Source: PubMed

New national growth references have been published in Belgium and Norway. The WHO recommends universal use of their 2006 Child Growth Standards based on data from breastfed children. To compare the growth of Belgian and Norwegian children with the WHO standards. 6985 children 0-5 years of age from Belgium and Norway. Proportion of children below -2 SD and above +2 SD of the WHO standards was calculated for length/height, weight, body mass index and head circumference. Average SD scores of exclusively breastfed children of non-smoking mothers were compared with national reference data and with the WHO standards. Generally, the number of Belgian and Norwegian children below -2 SD lines of the WHO standards was lower and above +2 SD higher than expected. The largest differences were for head circumference (0.97% Belgian and 0.18% Norwegian children below -2 SD, 6.55% Belgian and 6.40% Norwegian children above +2 SD) and the smallest for length/height (1.25% Belgian and 1.43% Norwegian children below -2 SD, 3.47% Belgian and 2.81% Norwegian children above +2 SD). The growth pattern of breastfed children of non-smoking mothers was in both countries more alike the local national growth references than the WHO standards. There are significant deviations in the proportion of children outside normal limits (±2 SD) of the WHO standards. This was true for all children, including those who were exclusively breastfed. Hence, adoption of the WHO growth charts could have consequences for clinical decision-making. These findings advocate the use of national references in Belgium and Norway, also for breastfed children.

    • "e, it was shown that mean BMI z-scores in United Kingdom, Belgian, Dutch, and American children were also lower than the WHO growth charts between birth and 5 months. We and others , showed that breastfeeding did not completely explain this trough, since the same pattern of z-score was observed in exclusively breastfed and never breastfed children. [25,27]It is worth highlighting that, if the WHO growth charts were used in France, most of the children would be considered as having a slow growth during the first three months of life. In particular, from 4 to 6 months, the prevalence of stunting according to the WHO definition (below −2SD from the median length-for-age) would be about 5%"
    [Show abstract] [Hide abstract] ABSTRACT: Growth charts are an essential clinical tool for evaluating a child's health and development. The current French reference curves, published in 1979, have recently been challenged by the 2006 World Health Organization (WHO) growth charts. To evaluate and compare the growth of French children who were born between 1981 and 2007, with the WHO growth charts and the French reference curves currently used. Anthropometric measurements from French children, who participated in 12 studies, were analyzed: 82,151 measurements were available for 27,257 children in different age groups, from birth to 18 years. We calculated and graphically compared mean z-scores based on the WHO and French curves, for height, weight and Body Mass Index (BMI) according to age and sex. The prevalence of overweight using the WHO, the French and International Obesity Task Force definitions were compared. Our population of children was on average 0.5 standard deviations taller than the French reference population, from the first month of life until puberty age. Mean z-scores for height, weight and BMI were closer to zero based on the WHO growth charts than on the French references from infancy until late adolescence, except during the first six months. These differences not related to breastfeeding rates. As expected, the prevalence of overweight depended on the reference used, and differences varied according to age. The WHO growth charts may be appropriate for monitoring growth of French children, as the growth patterns in our large population of French children were closer to the WHO growth charts than to the French reference curves, from 6 months onwards. However, there were some limitations in the use of these WHO growth charts, and further investigation is needed.
    Full-text · Article · Mar 2015 · PLoS ONE
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    • "By using the WHO 2006 standards, an additional 6.1% of children are defined as having stunted growth, with 7.1% as underweight, as compared to 2.2% for both stunting and underweight using our datasets (Table 5). A growth comparison of Belgian and Norwegian children with the WHO growth standards recommended that locally-developed growth references were more favourable rather than the 2006 WHO growth standards in terms of the growth discrepancies (Juliusson et al., 2011). The WHO standards were not meant to represent the growth characteristics of the average children in a population. "
    [Show abstract] [Hide abstract] ABSTRACT: Abstract Background: Growth references are useful for the screening, assessment and monitoring of individual children as well as for evaluating various growth promoting interventions that could possibly affect a child in early life. Aim: To determine the growth centiles of Malaysian children and to establish contemporary cross-sectional growth reference charts for height and weight from birth to 6 years of age based on a representative sample of children from Malaysia. Methods: Gender- and age-specific centile curves for height and weight were derived using the Cole's LMS method. Data for this study were retrieved from Malaysian government health clinics using a two-stage stratified random sampling technique. Assessment of nutritional status was done with the SD scores (Z-scores) of WHO 2006 standards. Results: Boys were found to be taller and heavier than girls in this study. The median length of Malaysian children was higher than the WHO 2006 standards and CDC 2000 reference. The overall prevalence of stunting and underweight were 8.3% and 9.3%, respectively. Conclusions: This study presents the first large-scale initiative for local reference charts. The growth reference would enable the growth assessment of a Malaysian child compared to the average growth of children in the country. It is suggested that the use of WHO 2006 Child Growth Standards should be complemented with local reference charts for a more wholesome growth assessment.
    Full-text · Article · May 2014 · Annals of Human Biology
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    • "Another often occurring problem is zscore , which is calculated in comparison to the CDC growth charts. The most recent publications, which focus on the problem of using international standards, show that global growth charts are inadequate in comparison to the regional charts1415161718 . Zscore should be calculated based on reference standards valid for the country of origin of the patient. "
    [Show abstract] [Hide abstract] ABSTRACT: Mucopolysaccharidosis type II (MPS II; Hunter syndrome) is an X-linked, recessive, lysosomal storage disorder caused by deficiency of iduronate-2-sulfatase. Early bone involvement leads to decreased growth velocity and short stature in nearly all patients. Our analysis aimed to investigate the effects of enzyme replacement therapy (ERT) with idursulfase (Elaprase) on growth in young patients with mucopolysaccharidosis type II. Analysis of longitudinal anthropometric data of MPS II patients (group 1, n = 13) who started ERT before 6 years of age (range from 3 months to 6 years, mean 3.6 years, median 4 years) was performed and then compared with retrospective analysis of data for MPS II patients naïve to ERT (group 2, n = 50). Patients in group 1 received intravenous idursulfase at a standard dose of 0.58 mg/kg weekly for 52-288 weeks. The course of average growth curve for group 1 was very similar to growth pattern in group 2. The average value of body height in subsequent years in group 1 was a little greater than in group 2, however, the difference was not statistically significant. In studied patients with MPS II, idursulfase did not appear to alter the growth patterns.
    Full-text · Article · Jan 2014 · PLoS ONE
    0Comments 7Citations
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