Novel type of references for weight aligned for onset of puberty – using the QEPS growth model

Background Growth references are traditionally constructed relative to chronological age, despite inter-individual variations in pubertal timing. A new type of height reference was recently developed allowing growth to be aligned based on onset of pubertal height growth. We here aim to develop a corresponding reference for pubertal weight. Methods To model QEPS-weight, 3595 subjects (1779 girls) from GrowUp1974Gothenburg and GrowUp1990Gothenburg were used. The QEPS-height-model was transformed to a corresponding QEPS-weight-model; thereafter, QEPS-weight was modified by an individual, constitutional weight-height-factor. Longitudinal weight and length/height measurements from 1418 individuals (698 girls) from GrowUp1990Gothenburg were then used to create weight references aligned for height at pubertal onset (the age at 5% of P-function growth, AgeP5). GrowUp1974Gothenburg subgroups based on pubertal timing, stature at pubertal onset, and childhood body composition were assessed using the references. Results References (median, SDS) for total weight (QEPS-functions), weight specific to puberty (P-function), and weight gain in the absence of specific pubertal growth (basic weight, QES-functions), allowing alignment of individual growth based on age at pubertal onset. For both sexes, basic weight was greater than average for late maturing, tall and high-BMI subgroups. The P-function-related weight was greater than average in short and lower than average in tall children, in those with high BMI, and in girls but not boys with low BMI. Conclusions New pubertal weight references allow individual variations in pubertal timing to be taken into consideration when evaluating growth. When used together with the comparable pubertal height reference, this will improve growth monitoring in clinical practice for identifying abnormal growth and serve as a valuable research tool providing insight into human growth.

Development of Local Percentile Growth Charts of Children between Birth to Ten Years

Growth pattern of human population changes with time and place. Particularly developing countries, country like India, is in a stage of nutritional transition hence it is necessary to update growth references regularly. The present study is carried out on 0-10 years from Baramati from Pune district of Maharashtra. We considered that children from maternity homes, BCG camps, well baby clinics, immunization camps, private clinics, ‘Anganwadis and Balwadis’, Nurseries’ and schools etc. Our study shows that growth performance of Anthropometric indices for Baramati children is much less than National Centre of Health Statistics (NCHS) and slightly less than Indian Council of Medical Research ICMR and Affluent Indians (AI). We have proposed growth charts for Baramati region to monitor growth parameters. Keywords: Anthropometric Indices, NCHS, ICMR, AI.

Are the Growth Standards of the World Health Organization Valid for Spanish Children? The SONEV Study

Background: The use of different growth tables to assess the population's nutritional status has given rise to a series of limitations arising from the lack of consensus and uniform methodological criteria. This leads to a disparity of results that prevent an accurate and reliable diagnosis of whether a child is overweight or obese.Objective: The purpose of this study was to develop growth references for weight, height, and body mass index for Eastern-Spanish children from 6 to 16 years of age.Methods: The final sample used to fit the growth curves was made up of 1,102 observations. The 2007 WHO curves are currently used for Child Health Service Cards. Therefore, to make the comparison of the internal values obtained as realistic as possible, the same construction method has been used for the internal curves, modeling age as a continuous variable and simultaneously adjusting the curves, smoothing them using cubic splines and further smoothing the edge effects by means of data extending above or below the upper and lower age limits.Results: Growth curves for percentiles were constructed for both sexes and higher values were noticeably found to set as growth-standard compared to WHO-standards.Conclusion: Our analysis shows that the WHO 2007 standard references are not suitable for Eastern-Spanish children. The standards shown in this study are much more realistic and current, and we believe that their use will help healthcare professionals more effectively combat the current epidemic of overweight and obesity.

Construction of China national newborn growth standards based on a large low-risk sample

Most published newborn growth references are based on conventional monitoring data that usually included both low- and high-risk pregnancies. We sought to develop a set of neonatal growth standards constructed from only a large sample of low-risk pregnancies. A total of 24,375 naturally conceived singleton live births with gestational ages of 24–42 weeks were collected in 69 hospitals in thirteen Chinese cities between 2015 and 2018. Unhealthy infants or those with high-risk mother were excluded. Smoothed percentile curves of six anthropometric indicators were established using the Generalized Additive Model for Location, Scale and Shape. The 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile references for birth weight, length, head circumference, weight/length, body mass index, and ponderal index were calculated for neonates with gestational ages of 24–42 weeks. This set of neonatal growth standards with six anthropometric indicators can provide more tools for growth and nutrition assessment and body proportionality in neonatal clinical practice. These standards might also help to show the differences between growth curves based on low-risk and mixed low- and high-risk pregnancies.

P–768 Childhood growth of singletons conceived following in vitro fertilization (IVF) - does gonadotropin-stimulation matter?

Study question Is there a difference in growth or weight gain of children conceived after IVF with or without gonadotropin-stimulation compared to standard growth references? Summary answer: We observed no difference in growth between children conceived after IVF with or without gonadotropin-stimulation and spontaneously conceived children. What is known already In recent studies, singletons conceived after IVF cycles had lower birth weight than spontaneously conceived singletons. The etiology of the impaired intrauterine growth is unclear, but insufficiency of placental function or possible epigenetic effects is discussed. Data regarding normalization or continuation of reduced birth weight are controversial. The growth of children born after unstimulated natural cycle IVF (NC-IVF) has never been studied. Study design, size, duration Single-center, university based cohort study. 139 singletons born after NC- IVF and children born after conventional gonadotropin stimulated IVF (cIVF) in 2010 –2017 were studied. Stimulation dosage in cIVF was ≥150 IU/d human gonadotropin. Participants/materials, setting, methods We collected weight, length and head circumference at birth and at one, two, four, six, 12, 18 and 24 months. We calculated standard deviation scores based on national growth references. Growth parameters (weight, length and head circumference) were compared between NC-IVF and cIVF singletons (stimulated with ≥150 IU/d human gonadotropin) using Mann-Whitney U tests. Main results and the role of chance In general, growth of children conceived after IVF did not differ from national references. Of the 139 singletons conceived, 98 singletons were conceived after NC-IVF and 41 after cIVF. The parents did not differ in ethnicity, age, BMI or health status between groups, and there was no significant difference in gestational age, pregnancy complications and smoking or breastfeeding habits either. The median birth weight in NC-IVF children was 3.4kg (0.1 standard deviation score, SDS) and in cIVF 3.3kg (–0.3 SDS) (p = 0.53). Median length at birth in NC-IVF was 50cm (–0.5 SDS) and did not differ from cIVF children 50cm (–0.8 SDS) (p = 0.52). At age 12 months, the median weight was 9.3kg (0.0 SDS) for NC-IVF children compared to 9.0kg (–1.7 SDS) for cIVF children (p = 0.44). Median lengths was 75cm (0.1 SDS) in NC-IVF versus 71cm (–1.6 SDS) in cIVF children (p = 0.89). At age 24 months, median weight in NC-IVF children was 12.3 kg (0.3 SDS) versus 10.5 kg (–1.2 SDS) in cIVF (p = 0.72) and median lengths 87.5cm (0.1 SDS) in NC-IVF versus 87.6 cm (0.1 SDS) in cIVF children. These discrete non-significant differences in weight and length gain compared to standardized growth curves and between the two groups are reassuring. Limitations, reasons for caution Willingness to participate is prone to selection bias. Further studies with larger samples are needed to confirm these findings. Wider implications of the findings: This is the first study investigating weight and length gain in children after unstimulated IVF. Growth is an important proxy for the health of children. These reassuring results are of imminent importance for the children born after IVF and their parents. Trial registration number BASEC (ID 2015–00235)

Validation of growth standards and growth references: A review of literature

The World Health Organization (WHO) growth standards provide the most recognized and widely accepted way of assessing child growth. To ensure its applicability, accuracy, and reliability, studies have validated WHO growth standards against local populations and other internationally recognized growth references. We reviewed outcomes of evaluations done on WHO growth standards and assess the appropriateness of using these growth standards on a global level. We undertook a systematic quantitative review of studies published from 2011 to 2020 from multiple databases. Studies were included if they considered children aged 59 months and below and reported on validation of growth standards. There was an agreement in studies that validated WHO growth standards against international growth references of its superiority in identifying stunted, overweight, and obese children. However, they were less likely to identify underweight children. None of the studies reviewed reported similar growth trajectories to WHO standards in all indicators considered. Regional differences in child growth were observed in comparison to WHO growth standards. Adoption of regional-specific standards increases the sensitivity of identifying children with adverse nutrition outcomes.

Application of the WHO (2007) Growth Reference in Assessing the Anthropometric Status of Nigerian Adolescents; a Systematic Review and Meta Analysis

Objectives The study was designed to assess the application of WHO 2007 growth reference by local studies published from 2008 to 2020 in data generation of Nigerian adolescents’ anthropometric status. Methods Meta-analysis of literatures on anthropometric status of adolescents in Nigeria by articles published from 2009–2020 was conducted. A bibliographic survey was carried out in several databases –Google Scholar, PubMed and African Journal Online. Review of abstracts and full texts followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The methodology for anthropometric assessment of these eligible studies were compared to WHO 2007 growth reference. Data was analysed using IBM SPSS version 25. Results A total of 24 articles which captured 12,482 adolescents met the inclusion criteria. More than one fifth (20.8%) of the studies adopted the WHO 2007 growth references in their data generation. A weak positive correlation was observed between year of publication and application of WHO 2007 reference in data generation (r = .0.28; p = 0.04). Conclusions The low application of an age long guideline by local researchers is of concern. Hence, the need to ensure quick adoption of standard indicators/guidelines in local studies will not only promote the generation of pooled evidence to reveal cross-cutting gaps but also ensure that the public health situation is not under/over estimated. Funding Sources This research work received no funding.

Growth in ataxia telangiectasia

Background Ataxia telangiectasia (A-T) is a DNA repair disorder that affects multiple body systems. Neurological problems and immunodeficiency are two important features of this disease. At this time, two main severity groups are defined in A-T: classic (the more severe form) and mild. Poor growth is a common problem in classic A-T. An objective of this study was to develop growth references for classic A-T. Another objective was to compare growth patterns in classic A-T and mild A-T with each other and with the general population, using the CDC growth references. A final objective was to examine the effects of chronic infection on height. Results We found that classic A-T patients were smaller overall, and suffered from height and weight faltering that continued throughout childhood and adolescence. When compared to the CDC growth references, the median heights and weights for both male and female patients eventually fell to or below the 3rd centile on the CDC charts. Height faltering was more pronounced in females. Birthweight was lower in the classic A-T group compared to mild A-T and the general population, whereas birth length was not. Finally, we investigated height and BMI faltering in relation to number of infections and found no association. Conclusions Classic A-T appears to affect growth in utero. Although children appear to grow well in very early life, faltering begins early, and is unrelenting.

BMI status relative to international and national growth references among Pakistani school-age girls

The authors have requested that this preprint be withdrawn due to erroneous posting.