To optimize pediatric growth monitoring, Anu Tresa and colleagues evaluated how different reference standards affect stature classification in children under 5 years. The study aimed to compare the proportion of children categorized as normal, short, severe short, or tall using standard WHO (2006) parameters versus regional Indian (2019) synthetic growth charts.
Therefore, the study evaluated 1,557 apparently healthy children presenting for routine vaccinations in Western India. Using calculated Z-scores, researchers categorized and compared stature classifications between WHO and Indian growth references.
Key Clinical Findings of the Study Include:
Normal Stature Categorization: Investigators discovered that a substantially higher proportion of the pediatric cohort, exactly 85.4%, was classified as having normal height on the 2019 Indian synthetic charts, compared to only 73.5% when evaluated with the WHO charts.
Mean Z-Score Variations: Researchers reported that the mean height-for-age Z-score demonstrated a significant clinical shift, recorded as -0.85 (+/-1.62) using WHO standards versus a much narrower -0.37 (+/-1.38) with the 2019 synthetic metrics.
Prevalence of Short Stature: Investigators confirmed that the calculated prevalence of short stature dropped noticeably from 15.03% on the international growth charts to just 7.77% when clinicians applied the regional Indian charts.
Severe Short Stature Rates: Researchers noted a corresponding and crucial decrease in severe short stature classifications, which fell sharply from 7.51% under WHO criteria to only 2.38% with the regional synthetic references.
The results suggest that utilizing standard WHO growth charts leads to a 12.4% overdiagnosis of short stature within an otherwise normal, healthy population of children under five years old. Consequently, the total prevalence of short stature was recorded at an inflated 22.54% with international parameters, compared to a more representative 10.15% with localized criteria.
Thus, the study concludes applying regional synthetic growth charts in daily pediatric practice may help lower the overall clinical burden by reducing the likelihood that healthcare providers will unnecessarily investigate and test children who are actually developing normally.
Because the available source document represents a concise study overview, it does not detail explicit methodological limitations or outline specific requirements for future clinical research, meaning healthcare professionals should interpret these findings primarily within the context of the observed outpatient population.
Reference
Tresa, A., Khadilkar, V., Jahagirdar, R., Deshpande, R., & Kore, V. (2026). Change in Grading of Stunting in Children aged 0–5 years in a Tertiary Hospital in Western India by Using WHO vs. Indian References. Indian Journal of Pediatrics, Issue 1/2026.
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