Abstract Objective: To determine if the National Center for Health Statistics (NCHS) growth curves (including 867 white infants, born between 1929 and 1975, in the Yellow Springs, Ohio, area) reflect contemporary infant growth in pediatric practices. Design: Observational cohort study of healthy term infants. Office personnel obtained standardized measurements at health maintenance visits. Setting: Ten pediatric community practices that were members of the Chicago, Ill, area Pediatric Practice Research Group (PPRG). Methods: Measurements of 1574 PPRG infants, seen on at least 5 occasions between 2 and 54 weeks of age, generated sex-specific growth curves using a 3-parameter mathematical model fitted to the serial data for each infant. Values from the computed curves were compared with NCHS growth references at 1,3,6,9, and 12 months. The birth weights of PPRG and NCHS cohorts were compared. Results: Mean birth weight of PPRG infants was significantly greater than a similar NCHS measure. Compared with the NCHS reference curve, PPRG infants were heavier at 1, 3, and 6 months, longer on all comparisons, and had greater head circumferences, particularly in the early months of age. Conclusions: The NCHS growth curves do not accurately reflect infant growth in this cohort. Nationally representative data are needed to revise the NCHS growth curves.Arch Pediatr Adolesc Med. 1996;150:842-849 References 1. Hamill PVV, Drizd TA, Johnson CL, Reed RB, Roche AF. NCHS/CDC Growth Curves for Children: Birth-18 Years, United States . Washington, DC: Dept of Health, Education, and Welfare; 1977. Vital and Health Statistics, series 11, No. (165) . DHEW publication (PHS) 78-1650. 2. Hamill PVV, Drizd TA, Johnson CL, Reed RB, Roche AF, Moore WM. Physical growth: National Center for Health Statistics percentiles . Am J Clin Nutr . 1979; 32:607-629. 3. Christoffel KK, Binns HJ, Stockman JA, et al. Practice-based research: opportunities and obstacles . Pediatrics . 1988;82:399-406. 4. Lohman TG, Roche AF, Martorell R. eds. Anthropometric Standardization Reference Manual 1988 . Champaign, Ill: Human Kinetics Publishers; 1988:3-8, 40-41. 5. SAS. Version 6.06. Cary, NC: SAS Institute Inc; 1991. 6. Fleiss JL. The Design and Analysis of Clinical Experiments . New York, NY: Wiley & Sons; 1986:1-31. 7. Roche AF, Guo S, Moore WM. Weight and recumbent length from 1 to 12 mo of age: reference data for 1-mo increments . Am J Clin Nutr . 1989;49: 599-607. 8. National Center for Health Statistics. Vital Statistics of the United States, 1988, Vol. 1, Natality . Washington, DC; Public Health Service: 1990. DHHS publication PH90-1100. 9. Dibley MJ, Goldsby J, Staehling N, Trowbridge FL. Development of normalized curves for the international growth reference: historical and technical considerations . Am J Clin Nutr . 1987;46:736-748. 10. SPSS/PC+. Version 5.0. Chicago, Ill; SPSS Inc: 1992. 11. SigmaPlot. San Rafael, Calif; Jandel Scientific: 1992. 12. Dibley MJ, Staehling N, Neiburg P, Trowbridge FL. Interpretation of z score anthropometric indicators derived from the international growth reference . Am J Clin Nutr . 1987;46:749-762. 13. Dean AG, Dean AJ, Coulombier D, et al. Epi Info, Version 6: A Word Processing, Database, and Statistics System for Epidemiology on Microcomputers . Atlanta, Ga: Centers for Disease Control and Prevention; 1994. 14. Guo S, Roche AF, Fomon SJ, et al. Reference data on gains in weight and length during the first two years of life . J Pediatr . 1991;119:355-362.Crossref 15. Gayle HD, Yip R, Frank MJ, Neiberg PI, Birkin NJ. Validity of maternally reported birthweight among 46,637 Tennessee WIC program participants . Public Health Rep . 1988;103:143-147. 16. Casey R, Rieckhoff M, Beeke SA, Pinto-Martin J. Obstetric and perinatal events: the accuracy of maternal report . Clin Pediatr . 1992;29:200-204.Crossref 17. Little RE. Birthweight and gestational age: mother's estimates compared with state and hospital records . Am J Public Health . 1986;76:1350-1351.Crossref 18. Guo S, Roche AF, Moore WM. Reference data for head circumference and 1-month increments from 1 to 12 months of age . J Pediatr . 1988;113:490-494.Crossref 19. Roche AF, Mukherjee D, Guo S, Moore WM. Head circumference reference data: birth to 18 years . Pediatrics . 1987;79:706-712. 20. Roche AF, Himes JH. Incremental growth charts . Am J Clin Nutr . 1980;33: 2041-2052. 21. Guo S, Roche AF, Yeung DL. Monthly growth status from a longitudinal study of Canadian infants . Can J Public Health . 1990;81:215-221. 22. Ryan AS. The physical growth of infants 7 to 13 months of age: results from a national survey . Am J of Phys Anthropol . 1987;73:449-457.Crossref 23. National Center for Health Statistics. Executive Summary of NCHS Growth Chart Workshop . College Park, Md: National Center for Health Statistics, The Division of Health Examination Statistics; 1992.
Archives of Pediatrics & Adolescent Medicine – American Medical Association
Published: Aug 1, 1996