Conflict of interest: None.
Comparison of Centers for Disease Control and Prevention and World Health Organization references/standards for height in contemporary Australian children: Analyses of the Raine Study and Australian National Children's Nutrition and Physical Activity cohorts
Article first published online: 22 JUN 2014
© 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 50, Issue 11, pages 895–901, November 2014
How to Cite
Hughes, I., Harris, M., Cotterill, A., Garnett, S., Bannink, E., Pennell, C., Sly, P., Leong, G. M., Cowell, C., Ambler, G., Werther, G., Hofman, P., Cutfield, W. and Choong, C. S. (2014), Comparison of Centers for Disease Control and Prevention and World Health Organization references/standards for height in contemporary Australian children: Analyses of the Raine Study and Australian National Children's Nutrition and Physical Activity cohorts. Journal of Paediatrics and Child Health, 50: 895–901. doi: 10.1111/jpc.12672
- Issue published online: 6 NOV 2014
- Article first published online: 22 JUN 2014
- Manuscript Accepted: 13 MAY 2014
- University of Western Australia (UWA)
- Telethon Institute for Child Health Research
- Raine Medical Research Foundation
- UWA Faculty of Medicine
- Dentistry and Health Sciences
- Women's and Infant's Research Foundation
- Curtin University
- growth standard;
- growth reference;
- Raine Study
(i) To compare the Centers for Disease Control and Prevention (CDC) reference and World Health Organization (WHO) standard/reference for height, particularly with respect to short stature and eligibility for growth hormone (GH) treatment by applying them to contemporary Australian children; (ii) To examine the implications for identifying short stature and eligibility for GH treatment.
Children from the longitudinal Raine Study were serially measured for height from 1991 to 2005 (2–15-year-old girls (660) and boys (702) from Western Australia). In the cross-sectional Australian National Children's Nutrition and Physical Activity survey (2–16-year-old boys (2415) and girls (2379) from all states), height was measured in 2007. Heights were converted to standard deviation scores (SDSs) based on CDC and WHO.
Means and standard deviations of height-SDS varied between CDC and WHO definitions and with age and gender within each definition. However, both identified similar frequencies of short stature (<1st centile for GH eligibility), although these were very significantly less than the anticipated 1% (0.1–0.7%) of the Australian cohorts. Mean heights in the Australian cohorts were greater than both the WHO and CDC means.
Neither CDC nor WHO height standardisations accurately reflect the contemporary Australian child population. Australian children are taller than the CDC or WHO height means, and significantly less than 1% of Australian children are defined as being short using either CDC or WHO. This study suggests there may be a case for an Australian-specific standard/reference for height.