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Differences in growth of Canadian children compared to the WHO 2006 Child Growth Standards
Author(s) -
Park Alison L.,
Tu Karen,
Ray Joel G.
Publication year - 2017
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/ppe.12377
Subject(s) - percentile , medicine , demography , confidence interval , body mass index , cohort , ethnic group , pediatrics , birth weight , pregnancy , statistics , mathematics , sociology , biology , anthropology , genetics , pathology
Background To evaluate if there are departures from the WHO Child Growth Standards ( WHO ‐ CGS ) in postnatal growth of healthy ‘Canadian’ children in Ontario up to age 2 years, including by infant feeding and ethnicity. Methods We included data on 9964 healthy, singleton children born in Ontario, Canada. Smoothed weight, length and body mass index ( BMI ) percentile curves were generated using quantile regression for the Canadian cohort from birth to age 2 years. Differences in percentile values were calculated comparing Canadian children vs. the WHO ‐ CGS . Results Canadian children under age 2 years were longer than the WHO ‐ CGS at the 10th (0.8 cm), 50th (1.3 cm) and 90th (1.9 cm) percentiles. Canadian children incrementally surpassed the WHO ‐ CGS in weight after age 6 months, and in BMI after 9 months. By age 2 years, the 50th percentile weight of Canadian males was 823 g (95% confidence interval ( CI ) 680, 965) higher than the WHO ‐ CGS 50th percentile. Weight differences were seen regardless of feeding practice, and were greatest among children of mothers born in Canada and Europe/Western nations, and least for those of East Asian/Pacific or South Asian heritage. Among Canadian breastfed males, 18% (95% CI 16, 19) of newborns and 26% (95% CI 20, 33) toddlers aged 2 years were classified by WHO ‐ CGS as weighing >90th percentile – much higher than the expected rate of 10%. Similarities were seen for differences in BMI . Conclusions Healthy Canadian infants/toddlers are longer and heavier than the WHO ‐ CGS norms. Explanations for these discrepancies require further elucidation.