Hong Kong Med J 2011;17:174–9 | Number 3, June 2011
Implications of using World Health Organization growth reference (2007) for identifying growth problems in Hong Kong children aged 6 to 18 years
HK So, EAS Nelson, Rita YT Sung, PC Ng
Department of Paediatrics, The Chinese University of Hong Kong, 6/F Clinical Science Building, Prince of Wales Hospital, Shatin, Hong Kong
OBJECTIVE. To evaluate the implications of replacing Hong Kong’s 1993 growth references (HK1993) with the World Health Organization’s 2007 references (WHO2007) for children aged 6 to 18 years.
DESIGN. Cross-sectional study.
SETTING. Thirty-six randomly selected primary and secondary schools in Hong Kong.
PARTICIPANTS. A total of 14 842 children and adolescents aged 6 to 18 years in Hong Kong during 2005/06.
MAIN OUTCOME MEASURES. Creation of age-specific z-scores for height, weight, and body mass index relative to HK1993 and WHO2007 references.
RESULTS. Use of WHO2007 instead of HK1993 could classify an additional 1.4% children aged 6 to 10 years and 2.8% children aged 11 to 18 years as having a short stature. Using WHO2007, respective proportions that could be classified as underweight and obese increased by 3.5% and 2.1% among children aged 6 to 10 years, and 5.5% and 1.6% among children aged 11 to 18 years.
CONCLUSIONS. Use of WHO2007 could increase clinical workload and patient and parent anxiety by ‘over-diagnosing’ short stature and underweight. Although WHO2007 may have a role in international comparative research, retention of HK1993 would seem appropriate from a clinical perspective.
Key words: Child development; Growth; Puberty; Reference values; Sex factors
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