Preeti Singh1, Sonal Gandhi1, Rajeev Kumar Malhotra2, Anju Seth3. 1. Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India. 2. Delhi Cancer Registry, BR Ambedkar IRCH, All India Institute of Medical Sciences; New Delhi, India. 3. Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India. Correspondence to: Dr Anju Seth, Director Professor, Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi 110 001, India. anju_seth@yahoo.com.
Abstract
OBJECTIVE: To compare the effect of the application of three growth references (Agarwal, 1992; Indian Academy of Paediatrics (IAP), 2015; and World Health Organisation (WHO), 2007) on interpretation of anthropometric parameters in schoolchildren. SETTING: Cross-sectional school-based study. PARTICIPANTS: Children 8-15 years studying in one government school and one private school of Delhi. PROCEDURE: The age- and gender-specific standard deviation scores of height-for-age and BMI-for-age were estimated for each student enrolled, using the three growth references independently. MAIN OUTCOME MEASURE: The proportion of children with short stature, thinness and overweight/ obesity determined by each growth reference were compared. RESULTS: A total of 1237 students participated in the study. A significantly higher proportion of children (both sexes) were classified to have short stature using WHO 2007 reference (8.8%) as compared to the Agarwal (3.3%) charts and IAP, 2015 references (3.6%). The combined prevalence of overweight and obesity was highest (34.8%) by the IAP, 2015 reference as against 32% by Agarwal charts and 29.1% by WHO, 2007 reference. Good agreement existed between the IAP, 2015 reference and Agarwal charts in classifying subjects into different BMI categories (Kappa=0.82) and short stature (Kappa=0.99). CONCLUSIONS: In view of differences noted, use of national population derived reference data is suggested to correctly define growth trajectories in children.
OBJECTIVE: To compare the effect of the application of three growth references (Agarwal, 1992; Indian Academy of Paediatrics (IAP), 2015; and World Health Organisation (WHO), 2007) on interpretation of anthropometric parameters in schoolchildren. SETTING: Cross-sectional school-based study. PARTICIPANTS: Children 8-15 years studying in one government school and one private school of Delhi. PROCEDURE: The age- and gender-specific standard deviation scores of height-for-age and BMI-for-age were estimated for each student enrolled, using the three growth references independently. MAIN OUTCOME MEASURE: The proportion of children with short stature, thinness and overweight/ obesity determined by each growth reference were compared. RESULTS: A total of 1237 students participated in the study. A significantly higher proportion of children (both sexes) were classified to have short stature using WHO 2007 reference (8.8%) as compared to the Agarwal (3.3%) charts and IAP, 2015 references (3.6%). The combined prevalence of overweight and obesity was highest (34.8%) by the IAP, 2015 reference as against 32% by Agarwal charts and 29.1% by WHO, 2007 reference. Good agreement existed between the IAP, 2015 reference and Agarwal charts in classifying subjects into different BMI categories (Kappa=0.82) and short stature (Kappa=0.99). CONCLUSIONS: In view of differences noted, use of national population derived reference data is suggested to correctly define growth trajectories in children.