Curvas de Crescimento: estamos a avaliar corretamente o crescimento das crianças em Portugal?

Abstract

Background and objective: Monitoring children's growth and development is fundamental to access quality health care. In 2004 the WHO developed healthy growth references to be applied worldwide, establishing how children were expected to grow if ideal health and nutrition conditions were present. This study aims to evaluate the growth evolution of children in a portuguese health unit, using anthropometric data records (weight, height and BMI) creating new growth curves representing portuguese children. The results were compared with the WHO curves to infer the appropriateness of their use in Portugal. Methods: Retrospective cohort study, accessing electronic health records of 10988 children from 0-5 years with follow-up at the Unidade Local de Saúde e Matosinhos (ULSM), born from 01/01/20210 to 31/12/2019. Systematic collection and percentile curve distribution of the variables weight, height and Body Mass Index, registered at each surveillance appointment at ULSM (0, 1, 2, 4, 6, 9, 12, 15, 15, 18, 24 months and 3, 4 and 5 years) . Results: The study population has differences between boys and girls in weight, height and BMI, with an average difference of 0.535 kg, 1.46cm and 0.27 kg/m2 less in girls. Comparing same aged children in our study with WHO study, boys have an average of 0.772kg less and 3cm less and girls have an average 0.806Kg and 3.15cm less; there were no differences found between average BMI in both studies, but our study's BMI overlaps the WHO study at the age of 15 months in girls and 18 months in boys. Conclusions: In this study, using large-scale national data we can infer that the WHO curves do not represent the portuguese children. Both Weight and Height are inferior in our population in all the ages analysed. Including all children in the study might bias the results as the Who study only focussed on full-term, breastfed and without significant morbidity children. Our results emphasise the importance of constructing national reference charts based on portuguese children.