Euro-growth references for length, weight, and body circumferences

Background: Several concerns have been raised by World Health Organization (WHO) expert groups regarding the adequacy of currently existing growth ref erences, including those currently supported by WHO. As part of a concerted action of the European Union, new references were developed that were base d on a well-defined sample of the European population and were compared wit h existing references. Methods: During the longitudinal, observational multicenter study, anthropo metric measurements using standardized methodology were performed in 2245 c hildren between 1 and 36 months of age, and sex- and age-specific growth re ferences for recumbent length, weight, mid-upper ann, thigh, and calf circu mferences were developed. Results: The validity of the curve-fitting programs was demonstrated by com paring the selected sex-specific percentile distributions for all indices w ith the smoothed references. Comparison with the National Center for Health Statistics (NCHS)-WHO references for length and weight for age indicated t hat the -2 z-score value of the WHO reference as cutoff value shows that a substantial pan of the children with suspected Failure to thrive should be classified as normal. The references also indicate that the mid-upper arm c ircumference is age and sex dependent and that a single cutoff value for ch ildren less than 5 years of age should no longer be used. Mid-parental heig ht was the best single predictor of recumbent length until 36 months of age . Conclusions: The Euro-Growth references that were developed reflect growth of a well-defined, large cohort of healthy infants and can be used for inte rnational comparisons. (C) 2000 Lippincott Williams & Wilkins, Inc.