ASSESSMENT OF DIFFERENCES BETWEEN THE NEW WORLD HEALTH ORGANIZATION CHILD-GROWTH STANDARDS AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION 2000 GROWTH CHARTS IN LATIN AMERICAN CHILDREN: WHICH REFERENCE SHOULD WE USE?
INTRODUCTION: Evaluation of growth patterns significantly depends on the reference used. Last year the World Health Organization (WHO) released new standards for assessing child growth during the first 5 years of life.
OBJECTIVE: Our goal was to assess differences between the 2000 Centers for Disease Control and Prevention (CDC) growth charts and 2006 WHO growth standards.
METHODS: A longitudinal study was conducted on a sample of 300 healthy children (167 boys and 133 girls) from a pediatric outpatient clinic in Mexico City. Weight-for-age z score, length/height-for-age z score, and weight-for-length/height z score were obtained yearly from birth to age 5 and compared by using the 2000 CDC growth charts and 2006 WHO growth standards.
RESULTS: Significant statistical differences were found at all ages in both genders. Main differences were found in early-infancy weight-for-age z scores. The prevalence of girls who were undernourished at birth was 3 times higher with the CDC reference than with that of the WHO (13.53% vs 4.50%, respectively), but the opposite was found for boys (2.99% vs 9.58%, respectively). During the first 4 years of life, a higher prevalence of length/height-for-age z scores less than −2.0 was found in both boys (10.77%) and girls (4.51%) when using WHO standards as opposed to the CDC charts. Furthermore, at the age of 5 years, obesity was significantly higher in girls according to WHO standards than in boys according to the CDC charts, although the CDC reference failed to detect a fast rate of weight gain in early infancy.
CONCLUSIONS: The new WHO standards are a better tool than the CDC charts for monitoring growth and detecting early overweight in Latin American children. Therefore, using this new international reference in daily clinical practice in our countries should be emphatically encouraged.
Submitted by Daniel Fuentes Lugo
- Copyright © 2008 by the American Academy of Pediatrics