MONITORING CHILDREN'S GROWTH

A systematic review of the routine monitoring of growth in children of primary school age to identify growth related conditions

Background

Assessment of a child's height and weight is well established as an indicator of their general health and well being. Monitoring height and weight to identify growth disorders including obesity might be a useful exercise. The current role of growth monitoring is unclear and uncertainties exist as to the most appropriate age(s) to measure and the measurement strategies to adopt. The aim of this review was to determine the clinical impact and cost-effectiveness of routinely monitoring growth in children between the ages of four and 11 years in order to identify growth related conditions, including obesity.

Findings

There is a lack of high quality evidence on the potential impact of such a monitoring programme, its acceptability and any potential harms. Gaps and uncertainties in the evidence base mean that growth monitoring does not currently meet all of the National Screening Committee criteria. Given that short stature is not a disease in itself, but rather is used as a marker for a range of pathologies and an indicator of a child's general health status, some of the National Screening Committee criteria may be inappropriate to growth monitoring.

The review found a lack of data on the potential impact of monitoring for obesity and more research is indicated. The cost-effectiveness model incorporated a great deal of uncertainty. Monitoring for obesity does not currently meet the majority of National Screening Committee criteria. Further long-term studies of the predictors of obesity related co-morbidities in adulthood is warranted.

Conducted by: D Fayter1 , J Nixon1, S Hartley1, A Rithalia1, G Butler2, M Rudolf3, P Glasziou4, M Bland5, L Stirk1, M Westwood1

1. Centre for Reviews and Dissemination; 2. Institute of Health Sciences, University of Reading; 3. Department of Community Paediatrics, University of Leeds; 4. Department for Primary Health Care, University of Oxford; 5. Department of Health Sciences, University of York

Further details

Project page on HTA Programme website

Publications

Fayter D, Nixon J, Hartley S, Rithalia A, Butler G, Rudolf M, Glasziou P, Bland M, Stirk L, Westwood M. A systematic review of the routine monitoring of growth in children of primary school age to identify growth-related conditions. Health Technol Assess. 2007;11(22):1-87

Westwood M, Fayter D, Hartley S, Rithalia A, Butler G, Glasziou P, Bland M, Nixon J, Stirk L, Rudolf M. Childhood obesity: should primary school children be routinely screened? A systematic review and discussion of the evidence. Arch Dis Child. 2007;92(5):416-22

Westwood M , Fayter D, Hartley S, Butler G, Rudolf M. Should we identify obesity through screening in primary schools? Rev Endocrinol July/August 2007

Fayter D , Nixon J, Hartley S, Rithalia A , Butler G, Rudolf M, Glasziou P, Bland M, Stirk L, Westwood M. Effectiveness and cost-effectiveness of height-screening programmes during the primary school years: a systematic review. Arch Dis Child. 2008;93:278-284

Funding

Commissioned by the HTA Programme