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Not What the Reference Curves Predict

Helen J. Binns, MD, MPH; Yvonne D. Senturia, MD, MSc; Susan LeBailly, PhD; Mark Donovan, MS; Katherine Kaufer Christoffel, MD, MPH

Arch Pediatr Adolesc Med. 1996;150(8):842-849.

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

Author Affiliations
From the Department of Pediatrics, Children's Memorial Hospital, Northwestern University, Chicago, Ill. Participating physicians are listed on page 849.

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