Revised birth centiles for weight, length and head circumference in the UK-WHO growth charts

Abstract

Background: The adoption in May 2009 by the UK of the WHO 2006 standard necessitated the provision of UK-based birth centiles for pre-term infants. The pre-existing British 1990 reference birth centiles, used in the UK since 1995, had been biased by the inclusion of post-natal data.

Aim: To describe the construction of new UK birth centiles for weight, length and head circumference, based on British 1990 reference data, but excluding post-natal data.

Subjects and methods: Birth data from the five original studies, collected between 1983–1993, were pooled and analysed by the LMS method, for the sexes separately. In addition, sex-specific composite centiles were constructed for infants born at term (37–42 completed weeks).

Results: The birth data included 9443 weights, 985 lengths and 1841 head circumferences, covering 23–44 weeks gestation. The analysis provided LMS tables defining reference centiles for weight and head circumference from 23–42 weeks and for length from 26–42 weeks. The term centiles are for use at age 0 on the post-natal 0–1 year chart.

Conclusion: These new centiles, replacing those of the British 1990 reference, are more accurate than their predecessors which were biased due to the inclusion of post-natal data.

Keywords::

• weight
• length
• head circumference
• growth charts
• birth

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Revised birth centiles for weight, length and head circumference in the UK-WHO growth charts

Acknowledgements

We thank all the other members of the RCPCH Growth Chart Expert Group and Linda Haines and staff within the RCPCH Science and Research Department for their project management support. We also thank the reviewer for helpful comments on the first version of the paper.

All authors collaborated in writing this article. TJC drafted it, and the other authors commented on each draft. TJC will act as guarantor of the paper.

This UK-WHO early years growth chart project was funded by a grant from the English Department of Health to the RCPCH. TJC is funded by Medical Research Council grant G0700961, based at GOSH/UCL Institute of Child Health which received a proportion of funding from the Department of Health's NIHR Biomedical Research Centres funding scheme. None of the funders had any influence on the writing of the paper.

Declaration of Interest: The authors are members of the RCPCH Growth Chart Expert Group. TJC and CMW have acted as advisers on certain elements of the WHO Multicentre Growth Reference Study. TJC receives occasional royalty payments from the Medical Research Council for his LMSchartmaker software which was used to construct the UK birth for gestation centiles.