#8+ bmi chart for kids
OBJECTIVES: To actuate the acceding amid weight-for-length and BMI-for-age in accouchement 0 to Download figureOpen in new tabDownload powerpointFIGURE 1
Participation application and acceptance flowchart from October 2008 to October 2014. aNonvalid z annual includes z array < −4.0 or >5.0 that (1) could not be compared with added well-child visits to actuate actuality and/or biological plausibility, or (2) were ≥1 SD of a z annual of a antecedent and/or consecutive well-child appointment aural 2 years.
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Baseline Characteristics of Accouchement 0 to Download figureOpen in new tabDownload powerpointFIGURE 2
Proportion (%) of observations classified into weight cachet categories by application weight-for-length and BMI-for-age.
The Pearson alternation amid weight-for-length and BMI-for-age was strong, positive, and statistically cogent (r = 0.985, P < .001). The Bland-Altman artifice appear that the beggarly of the differences amid weight-for-length and BMI-for-age was abreast 0 (difference = −0.079, SD = 0.19) and the aberration was not statistically cogent (P = .68). The consequence of the banned of acceding was < |0.5| (−0.46 to 0.31) and best observations were aural the 95% aplomb banned (Fig 3).
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Bland-Altman artifice demonstrating the acceding amid weight-for-length and BMI-for-age. Banned of acceding bare appraisal of aberration (weight-for-length z annual bare BMI-for-age z score) = −0.079; SD of the differences = 0.19, 95% CI −0.47 to 0.31, P = .68.
In the accessory assay stratified by age and sex, weight-for-length and BMI-for-age were acerb and absolutely activated in anniversary of the age and sex categories (r ≥ 0.979 for all coefficients, see Table 2). Back stratified by weight cachet categories, the arch alternation was empiric in the accustomed weight class (r = 0.97), but all correlations were able and absolute (underweight [r = 0.89], at-risk ample [r = 0.85], and ample [r = 0.87]). Figure 4 illustrates the allocation of observations into weight cachet categories. The all-embracing amount of misclassification was 6.3% (n = 138/2190). Misclassifications occurred abreast the cutoffs. The McNemar χ2 analysis appear that the admeasurement of observations misclassified was statistically cogent for crumbling (P < .001), but not for added weight cachet categories (P > .05 for all added categories).
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Pearson Alternation Amid Weight-for-Length and BMI-for-Age
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Scatterplot of weight-for-length and BMI-for-age comparing misclassification amid advance cachet categories. Red dots are those misclassified (eg, articular in one class by weight-for-length and in a altered class by BMI-for-age). Misclassification amount was 6.3% of absolute observations included (n = 138/2190).
Among those articular by application weight-for-length, best observations (sensitivity ≥0.77 for all weight cachet categories) were accurately classified in the aforementioned weight class by application BMI-for-age. Acuteness was the accomplished for crumbling (0.92) and everyman for at-risk ample (0.77, Table 3), admitting specificity was aerial in all categories (≥ 0.97). Aural anniversary weight cachet category, at atomic 75% were accurately articular in the aforementioned category; the everyman ante were empiric for crumbling (0.75) and at-risk ample (0.83, Table 3). The class with the accomplished PPV was ample (0.89). NPVs were aerial and agnate for wasting, at-risk overweight, and ample (≥ 0.97, See Table 3).
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Unadjusted Sensitivity, Specificity, PPV, and NPV by Application BMI-for-Age Compared With Weight-for-Length by Weight Cachet Category
We performed all declared analyses by application alone commonly calm abstracts and begin agnate after-effects back compared with research-collected abstracts (see Supplemental Tables 4, 5, and 6). The Pearson alternation accessory amid weight-for-length and BMI-for-age was 0.99 (P < .001). The beggarly aberration amid weight-for-length and BMI-for-age was −0.084 (SD = 0.20) and was not statistically cogent as bent by a Bland-Altman artifice (P = .67, abstracts not shown). Pearson alternation coefficients were agnate amid age and sex categories (see Supplemental Table 5). Acuteness and PPVs were accomplished amid crumbling (0.92) and ample (0.92) observations, respectively, admitting specificity was agnate and aerial in all categories (see Supplemental Table 6). Analyses were conducted on 1 about called ascertainment per adolescent and the after-effects were agnate (data accessible on request).
Our after-effects announce aerial acceding amid weight-for-length and BMI-for-age with low misclassification overall. The Bland-Altman plots were balanced on beheld analysis and no analytical bent was identified. Our after-effects approved aerial specificity (≥97%) and best of those articular in any weight cachet class were accurately classified (≥75%). Best misclassifications occurred abreast the cutoffs and misclassification was not statistically cogent for any weight cachet category, except for wasting. The acceding amid weight-for-length and BMI-for-age was analogously aerial in commonly calm data, advertence the abeyant for commonly calm abstracts to be acclimated for advance ecology and for analysis and accessible bloom purposes.
Previous analysis has authentic the use of BMI-for-age for advance ecology in the aboriginal 2 years of life. Nash et al15 appear a Pearson alternation accessory of 0.83 (P < .0001) amid weight-for-length and BMI-for-age in a baby (n = 547) citizenry recruited from a pediatric tertiary affliction setting. Nash et al15 included accouchement with abiding altitude affecting advance (eg, cystic fibrosis, abortion to thrive, complete defects) and 18% of the sample constituted preterm infants. Our exclusion of accouchement with abiding ache may accept resulted in a college alternation accessory (0.99, P < .001).
Nash et al15 additionally appear beneath accouchement articular as at-risk ample (ie, ≥85th percentile) by application BMI-for-age (12.5%) compared with weight-for-length (18.2%).15 We did not analyze any differences in prevalence at this blow or at added cutoffs. Our sample admeasurement was beyond and included alone advantageous children, which may annual for this difference. De Onis et al17 appear a agnate prevalence for weight-for-length and BMI-for-age in ample in accouchement 99.9th]). A baby sample admeasurement at these acute ethics impeded our adeptness to appraise the acceding in these weight cachet categories separately. Additionally, we afar those accouchement for whom bearing weight and gestational age were not accepted (n = 954); however, their admittance may accept provided added insight. Second, although we accept acclimated the recommended percentile cutoffs by the WHO to ascertain weight cachet categories, the authority of these categories in adolescent accouchement charcoal ailing understood. Many of these cutoffs were authentic for earlier accouchement alone or called as statistical, rather than clinical, criteria.25,28–30
Although weight-for-length was acclimated as the archetype measure, it may be argued that a added authentic and almost admeasurement of anatomy fat (eg, skinfold test, bifold activity x-ray absorptiometry) be advised a “gold standard” to appraise weight status.31–33 We did not aggregate abstracts on these measures in our study. Importantly, though, weight-for-length is the currently recommended admeasurement to use for advance ecology by the American Academy of Pediatrics4 and the Canadian Pediatric Society3 in children