ESPE Abstracts (2014) 82 P-D-3-3-844

WHO Growth Charts Replacing National Reference Data: Their Influence on Screening for Over- or Underweight and of Growth Disorders

Celine Eisenegger, Sarina Allenspach-Moser & Dagmar Lallemand


Childen’s Hospital of Eastern Switzerland, St Gallen, Switzerland


Background: In 2011, nationwide growth charts were introduced, replacing different regional references (ZLS, Prader 1989; Sempé 1979 and, for BMI only, Kromeyer 2001).

Objective and hypotheses: The aim was to examine the influence of new growth charts (WHO 2010) on the prevalence of nutrition- and growth-related disorders compared the ‘old’ references.

Method: 6007 anonymised weight and height datasets of children measured between 2000 and 2012 in one center were included. Precision of measurement was below 0.1% or 0.5 cm, respectively The degree of deviation of the ‘new’ from the ‘old’ percentile charts was assessed by the kappa measurement of agreement for different age groups.

Results: WHO-percentiles for length/height show a broader normal range and a good agreement with ZLS charts (κ 0.88–0.83) in boys and girls. Yet 2–9% of boys aged 2–15 years are now classified as normal, while they would have been defined as short statured before. Female height charts are broader now and, except for the age of puberty, classify more girls as normal, namely 4.7% of those having been short statured and 1.4% of those classified as too tall before. WHO-weight percentiles, of boys and girls, are shifted to a higher normal range than ZLS curves. In the first year of life, the new BMI-percentiles find 4% less obese infants, but at school age, obesity was identified by WHO-BMI-references in up to 10% more boys and 2% more girls than with references from Kromeyer.

Conclusion: For public health, the implementation of ‘new’ growth charts has an important impact on prevalence of growth-related disorders and obesity. WHO percentiles find less short statured and more obese school aged children than ‘old’ references, the additional use of further markers of growth or obesity should be added, such as parental target height or waist circumference.

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