Does measurement technique explain the mismatch between European head size and WHO charts?

Wright, C. M. , Bremner, M., Lip, S. and Symonds, J. D. (2017) Does measurement technique explain the mismatch between European head size and WHO charts? Archives of Disease in Childhood, 102(7), pp. 639-643. (doi: 10.1136/archdischild-2016-311888) (PMID:27986698)

Abstract

Objective To test whether different measuring techniques produce systematic differences in head size that could explain the large head circumferences found in Northern European children compared with the WHO standard. Design: Cross-sectional observational study. Setting: Scotland, UK. Patients: Study 1: 68 healthy children aged 0.4–18 months from mother and baby groups and a medical students teaching session. Study 2: 81 children aged 0.4 to 25 months from hospital wards and neonatal follow-up clinics. Interventions: Study 1: heads measured with plastic tape using both the WHO tight and UK loose technique. Study 2: heads measured using WHO research technique and a metal measuring tape and compared with routinely acquired measurements. Main outcome measures: Mean difference in head z-scores using WHO standard between the two methods. Results: The tight technique resulted in a mean (95% CI) z-score difference of 0.41 (0.27 to 0.54, p<0.001) in study 1 and 0.44 (0.36 to 0.53, p<0.001) in study 2. However, the mean WHO measurements in the healthy infants still produced a mean z-score that was two-third of a centile space (0.54 SD (0.28 to 0.79) p<0.001) above the 50th centile. Conclusion: The WHO measurement techniques produced significantly lower measures of head size, but average healthy Scottish children still had larger heads than the WHO standard using this method.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lip, Dr Stefanie and Wright, Professor Charlotte
• Authors: Wright, C. M., Bremner, M., Lip, S., and Symonds, J. D.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Archives of Disease in Childhood
• Publisher: BMJ Publishing Group
• ISSN: 0003-9888
• ISSN (Online): 1468-2044
• Published Online: 16 December 2016
• Copyright Holders: Copyright © 2017 BMJ Publishing Group
• First Published: First published in Archives of Disease in Childhood 102(7):639-643
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher