29-01-2025 | Original Article
Change in Grading of Stunting in Children aged 0–5 years in a Tertiary Hospital in Western India by Using WHO vs. Indian References
Authors:
Anu Tresa, Vaman Khadilkar, Rahul Jahagirdar, Ruma Deshpande, Vrushali Kore
Published in:
Indian Journal of Pediatrics
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Abstract
Objectives
To classify under 5-y-old children into normal, short, severe short and tall categories as per WHO (2006) and Indian 2019 synthetic growth charts and to compare the change in the proportion of stunted children based on these two charts.
Methods
This study was done on 1557 (795 boys) apparently healthy children of age group 0–5 y who attended outpatient clinics for routine vaccination and their stature categories were compared on WHO 2006 vs. 2019 Indian synthetic charts. Children were categorized into severe short, short, normal and tall on both charts by calculating z scores.
Results
On WHO charts 73.5% children were classified as normal vs. 85.4% on 2019 Indian synthetic charts. The mean Z score for height for age as per WHO was -0.85 (+/-1.62), whereas as for 2019 synthetic charts was -0.37 (+/-1.38). While using WHO growth charts the prevalence of short stature was 15.03%, and severe short stature was 7.51%, which dropped to 7.77% for short stature and 2.38% for severe short stature on 2019 synthetic charts, respectively.
Conclusions
WHO Growth charts overdiagnose short stature by 12.4% (WHO 22.54% vs. Indian synthetic 10.15%) in an apparently normal population of under five children. Use of regional growth charts may reduce the need to unnecessarily investigate normal children.