SynthesisBMJ open2014
Worldwide variation in human growth and the World Health Organization growth standards: a systematic review.
Synthesis in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 119 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
119 citing papers in PubMed, 1 synthesis or guideline pooled it, 298 citations in OpenAlex.
- Prevalence of high blood pressure in 122,053 adolescents: a systematic review and meta-regression.Medicine · 2014Pooled it
- Trial
- Growth of Infants Fed Formula with Evolving Nutrition Composition: A Single-Arm Non-Inferiority Study.Nutrients · 2017Trial
- Short Stature: Comparison of WHO and National Growth Standards/References for Height.PloS one · 2016Trial
- An EHR-based framework for modeling growth curves and constructing growth centile charts for genetic disorders.NPJ genomic medicine · 2026Article
- Neurophysiological and executive function differences among underweight, overweight, and normal-weight children and adolescents.Pediatric research · 2026Article
- Use of WHO Growth Standards Rather Than Locally Specific Linear Growth Curves Promotes Equity in Pediatric Growth Research for Children Younger Than 5 Years.Nutrition reviews · 2026Review
- Comparison of WHO and Centers for Disease Control and Prevention Growth References for Classifying Height and Weight Status in Young Children in the United States-Affiliated Pacific.Current developments in nutrition · 2026Article
- New growth charts for children and adolescents in Catalonia, Spain: developed from routinely collected data (2013-2019).BMC public health · 2026Article
- Postnatal growth trajectories of very preterm appropriate-for-gestational-age infants from term-equivalent age to 6 years.Pediatric research · 2026Article
- Do Anthropometric Health Risk Indicators of South African Primary School Children Require National Growth Charts? Insights from the NW-CHILD Study.Children (Basel, Switzerland) · 2026Article
- Overweight & obesity epidemic, temporal trends and regional disparities in physical growth of Vietnamese children.Scientific reports · 2026Article
- Telemedicine follow-up and nutritional outcomes in children with neurological impairment: a longitudinal study.Frontiers in pediatrics · 2026Article
- Growth Patterns in Shwachman-Diamond Syndrome: Findings from the North American Shwachman-Diamond Syndrome Registry.The Journal of pediatrics · 2025Article
- The performance of growth charts in well term newborns in screening for hypoglycemia.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Obesity: Clinical Impact, Pathophysiology, Complications, and Modern Innovations in Therapeutic Strategies.Medicines (Basel, Switzerland) · 2025Review
- Adult head circumference and the risk of cancer: a retrospective cohort study.Cancer causes & control : CCC · 2025Article
- Double Burden of Malnutrition in Under-Five Children (NFHS-5 Data) Using Extended CIAF: WHO 2006 Growth Standard Versus 2019 Indian Growth References.Indian pediatrics · 2025Article
- Delving Relationship between Head Circumference and Maxillary Anterior Teeth Dimensions.Journal of pharmacy & bioallied sciences · 2025Article
- Head Circumference Versus Length and Weight Deficits up to 2 Years of Age in Bangladesh.Maternal & child nutrition · 2025Article
59 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe World Health Organization (WHO) has established a set of growth curves for use as international standards in children up to age 5. The WHO's position is that all economically advantaged children who were breastfed as infants grow similarly. As a result, a single set of growth charts can be used to judge growth in any child, regardless of race or ethnicity. The goal of this study was to compare mean heights, weights and head circumferences from a variety of studies with the WHO's data.
designWe compared data from the WHO's Multicentre Growth Reference Study (MGRS) with data from studies performed in 55 countries or ethnic groups. DATA SOURCES: PubMed, WHO Global Database on Child Growth and Malnutrition, SciELO, Google Scholar, Textbooks and Ministries of Statistics and Public Health. ELIGIBILITY CRITERIA: Large recent studies (1988-2013) of economically advantaged groups, including comparisons with cohorts of breastfed children wherever possible.
resultsHeight varied somewhat among different national and ethnic groups. Means were generally within 0.5 of an SD of the MGRS means. Weight varied more than height, but the low MGRS means were seen as endorsing slenderness in the midst of an obesity epidemic. The mean head circumference varied widely. In many groups, means were consistently 0.5-1 SD above the MGRS mean. Head size in breastfed children at any age examined was far closer to local norms than to the MGRS means.
conclusionsHeight and weight curves may not be optimal fits in all cases. The differences between national or ethnic group head circumference means were large enough that using the WHO charts would put many children at risk for misdiagnosis of macrocephaly or microcephaly. Our findings indicate that the use of a single international standard for head circumference is not justified. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (# CRD42013003675).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.