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{{Short description|Graphic of child development over time}}
[[File:CDC growth chart boys birth to 36 mths cj41c017.pdf|thumbnail|Sample growth chart for use with American boys from birth to age 36 months.]]
A '''growth chart''' is used by [[Pediatrics|pediatricians]] and other health care providers to follow a child's growth over time. Growth charts have been constructed by observing the growth of large numbers of healthy children over time. The [[human height|height]], [[Human body weight|weight]], and [[head circumference]] of a child can be compared to the expected parameters of children of the same age and sex to determine whether the child is growing appropriately. Growth charts can also be used to predict the expected adult height and weight of a child because, in general, children maintain a fairly constant growth curve. When a child deviates from his or her previously established growth curve, investigation into the cause is generally warranted. Parameters used to analyze growth charts include weight velocity (defined as rate of change in weight over time), height velocity (defined as rate of change in stature over time), and whether someone's growth chart crosses percentiles. For instance, endocrine disorders can be associated with a decrease in height velocity and preserved weight velocity while normal growth variants are associated with a decrease in height and weight velocity that are proportional to each other. It's important to note that other parameters are more commonly used such as waist circumference for assessing obesity and skin fold difference for assessing malnutrition. Growth charts can also be compiled with a portion of the population deemed to have been raised in more or less ideal environments, such as nutrition that conforms to pediatric guidelines, and no [[Smoking and pregnancy|maternal smoking]]. Charts from these sources end up with slightly taller but thinner averages.<ref>{{cite web | url =https://www.who.int/childgrowth/standards/Technical_report.pdf | title = WHO Child Growth Standards | publisher = World Health Organization}}</ref>
[[File:Growth Curve Girl (WHO).jpg|thumb|200px|left|Growth curve of a girl, compared to the 2006 WHO curves
Growth charts are different for boys and girls, due in part to pubertal differences and disparity in final adult height. In addition, children born prematurely and children with chromosomal abnormalities such as [[Down syndrome]] and [[Turner syndrome]] follow distinct growth curves which deviate significantly from children without these conditions. As such, growth charts have been created to describe the expected growth patterns of several developmental conditions. Since there are differences in normal growth rates between breastfed and formula-fed babies,<ref>{{cite journal | pmid = 7651784 | year = 1995 | last1 = Dewey | first1 = KG | last2 = Peerson | first2 = JM | last3 = Brown | first3 = KH | last4 = Krebs | first4 = NF | last5 = Michaelsen | first5 = KF | last6 = Persson | first6 = LA | last7 = Salmenpera | first7 = L | last8 = Whitehead | first8 = RG | last9 = Yeung | first9 = DL | title = Growth of breast-fed infants deviates from current reference data: A pooled analysis of US, Canadian, and European data sets. World Health Organization Working Group on Infant Growth | volume = 96 | issue = 3 Pt 1 | pages = 495–503 | journal = Pediatrics | doi = 10.1542/peds.96.3.497 | s2cid = 20425748 }}</ref> the World Health Organization growth charts, which better reflect the growth pattern of the healthy, breastfed infant, are considered the standard for U.S. children under age two.<ref>{{cite web | url = https://www.cdc.gov/mmwr/pdf/rr/rr5909.pdf | title = Use of World Health Organization and CDC Growth Charts for Children Aged 0–59 Months in the United States | publisher = Centers for Disease Control}}</ref>▼
▲[[File:Growth Curve Girl (WHO).jpg|thumb|200px|left|Growth curve of a girl, compared to the 2006 WHO curves.]]
▲Since there are differences in normal growth rates between breastfed and formula-fed babies,<ref>{{cite journal | pmid = 7651784 | year = 1995 | last1 = Dewey | first1 = KG | last2 = Peerson | first2 = JM | last3 = Brown | first3 = KH | last4 = Krebs | first4 = NF | last5 = Michaelsen | first5 = KF | last6 = Persson | first6 = LA | last7 = Salmenpera | first7 = L | last8 = Whitehead | first8 = RG | last9 = Yeung | first9 = DL | title = Growth of breast-fed infants deviates from current reference data: A pooled analysis of US, Canadian, and European data sets. World Health Organization Working Group on Infant Growth | volume = 96 | issue = 3 Pt 1 | pages = 495–503 | journal = Pediatrics }}</ref> the World Health Organization growth charts, which better reflect the growth pattern of the healthy, breastfed infant are considered the standard for U.S. children under age two.<ref>{{cite web | url = https://www.cdc.gov/mmwr/pdf/rr/rr5909.pdf | title = Use of World Health Organization and CDC Growth Charts for Children Aged 0–59 Months in the United States | publisher = Centers for Disease Control}}</ref>
== History and
The growth chart was first developed by the [[National Center for Health Statistics]] (NCHS) in 1977 to clinically analyze child development. The 1977 growth chart was subsequently used by the [[World Health Organization]] for dissemination to healthcare systems abroad. In order to accommodate for heterogenous populations internationally, the WHO made an effort to gather data from different regions in every continent. Data used to calculate the CDC's growth chart percentiles was accumulated periodically since the
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== Quantitative
'''Mid-parental height (MPH)''' is
cTH_SDS = TH_SDS x 0.72
'''Velocity''' is another quantity that is used to quantify growth curves. It can be used for both height and weight. In the equation provided '''q''' is either weight or height, '''t''' represents time, and '''Δ''' represents change over a defined interval. Growth velocity is
▲'''Velocity''' is another quantity that is used to quantify growth curves. It can be used for both height and weight. In the equation provided '''q''' is either weight or height, '''t''' represents time, and '''Δ''' represents change over a defined interval. Growth velocity is defined as follows.<ref>{{Citation|last=Bozzola|first=Mauro|title=Growth Velocity Curves: What They Are and How to Use Them|date=2012|url=http://link.springer.com/10.1007/978-1-4419-1795-9_180|work=Handbook of Growth and Growth Monitoring in Health and Disease|pages=2999–3011|editor-last=Preedy|editor-first=Victor R.|place=New York, NY|publisher=Springer New York|language=en|doi=10.1007/978-1-4419-1795-9_180|isbn=978-1-4419-1794-2|access-date=2021-09-13|last2=Meazza|first2=Cristina}}</ref>
* <math>velocity = \Delta q/\Delta t</math>
'''[[Body mass index|Body mass index (BMI)]]''' is a useful quantification that can gauge level of obesity. It is defined as follows with the given clinical ranges.
* <math>BMI = weight(kg) / [height(m)]^2
* '''[[Obesity]]''': BMI > 95th percentile
* '''Overweight''': 85th < BMI < 95th percentile
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'''[[Bone age]]''' is another useful metric that complements a physician's use of a growth chart. It is particularly useful in working up growth abnormalities and can indicate a delay in onset of [[puberty]].
== Common
* '''Familial short
* '''Constitutional growth delay:''' Benign variant of normal height growth due to a delay in the onset of puberty. Expect a delayed bone age and a trajectory that is not on track for the target height.
* '''Endocrine
== Clinical
The combination of height and weight velocity can indicate underlying disease of genetic origin, endocrine cause, and/or delayed growth.
=== Normal
One of the most common growth disorders, a growth deficiency can be due to either familial short stature or constitutional growth delay (CGD). Familial short stature is indicative when one or both parents are of a short stature, and the height and weight percentiles are under the 5 percentile threshold.<ref name="y793">{{
=== Genetic
A variety of genetic syndromes can result growth chart patterns with a typical pattern. Genetic diseases such as [[Turner syndrome|Turner's syndrome]], [[Prader–Willi syndrome|Prader Willi]], and [[Noonan syndrome]] can be marked by a less than 5th percentile height and weight since birth.
=== Endocrine and
A decrease of height velocity with retained or increased weight velocity can be indicative of endocrine disorders including [[hypothyroidism]], [[growth hormone deficiency]], and excess of
== Variability in
The CDC's growth chart is utilized from a population that consists of a representative population in the USA. Charts based on a specific race or ethnicity are not useful because of the growth chart progression can be attributed to socioeconomic factors.<ref>{{Cite web|date=2019-01-23|title=Reference Population {{!}} Overview CDC Growth Charts {{!}} Growth Chart Training {{!}} NUtrition {{!}} DNPAO {{!}} CDC|url=https://www.cdc.gov/nccdphp/dnpao/growthcharts/training/overview/page4.html|access-date=2021-09-20|website=www.cdc.gov|language=en-us}}</ref> WHO launched a revised growth in 2006 chart using children from Ghana, Oman, Norway, Brazil, India and the USA that substantiated the fact that growth is highly dependent on environmental factors.<ref>{{Cite web|title=Growth Charts|url=http://adoptmed.org/topics/growth-charts.html|access-date=2021-09-20|website=Center for Adoption Medicine|language=en-US}}</ref>
==See also==
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* [https://www.who.int/childgrowth/standards/technical_report/en/index.html WHO information on growth charts]
* [https://www.who.int/childgrowth/en/ The WHO Child Growth Standards]
* [http://pediatrics.about.com/cs/growthcharts2/f/breastfeeding.htm Growth Charts and Breastfeeding Babies] {{Webarchive|url=https://web.archive.org/web/20150921211026/http://pediatrics.about.com/cs/growthcharts2/f/breastfeeding.htm |date=2015-09-21 }}
[[Category:Pediatrics]]
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