rowth and development of children is a very sensitive indicator of the general health and nutritional status of children in a populati- on. Therefore, the study of the effect of social class differences on
AABBSS TTRRAACCTT OObb jjeecc ttii vvee:: To update the weight and height centiles for a group of predominantly breast- fed children aged 0-2 years from the medium-high socioeconomic status living in Ankara. MMaatteerriiaall aanndd MMeetthhooddss:: The study design was prospective cohort. Between 2002 and 2004, height and weight meas- urements of 0-2 year-old healthy children from the medium-high socioeconomic status were recorded in definite time-intervals in the Healthy Child Clinic of Gazi University Faculty of Medicine. Height and weight percentile curves were constructed using the LMS method for boys and girls. RReessuullttss:: In height and weight percentile curves, a steady upward trend was detected until 24 months of age for each gender. The estimated 50thpercentiles of height and weight were mostly higher than the 50th percentiles suggested by the World Health Organization (WHO) 2006 and Neyzi 1978. The 50thheight and weight percentiles of the present study were closer to those of WHO than those of Neyzi. CCoonn-- cclluussiioonn:: The present study reports the updated percentile values and curves for height and weight in a group of predominantly breastfed children aged 0-2 years from the medium-high socioeconomic status in Ankara. However, since the obtained data does not represent the whole country, it may be more reasonable to use the updated WHO multicenter growth reference curves.
KKeeyy WWoorrddss:: Child; growth; growth&de ve lop ment; body he ight; body we ight chan ges Ö
ÖZZEETT AAmmaaçç:: Bu çalışmada, Ankara’da yaşayan, orta-yüksek sosyoekonomik düzeyden gelen ve ağırlıklı olarak anne sütü ile beslenen, 0-2 yaş arasındaki bir grup Türk çocuğu için ağırlık ve boy yüzdeliklerini güncellemek amaçlanmıştır. GGeerreeçç vvee YYöönntteemmlleerr:: Çalışma, ileriye dönük kohort şeklinde tasarlanmıştır. Orta-yüksek sosyoekonomik düzeyden gelen 0-2 yaş arasındaki Türk çocuklarının ağırlık ve boy ölçümleri, 2002-2004 yılları arasında Gazi Üniversitesi Tıp Fakültesi Sağlıklı Çocuk Kliniği’nde belirli aralıklarla kaydedilmiştir. Ağırlık ve boy yüzdelik eğrileri LMS yöntemiyle oluşturulmuştur. BBuullgguullaarr:: Hesaplanan yüzdelik değerleri, erkek çocukların kız çocuklarından daha büyük ağırlık ve boy değerlerine sahip olduğunu göstermektedir. Ağırlık ve boy yüzdelik eğrilerinde erkek ve kız çocuklar için 24 aylık yaşa kadar yukarı doğru bir eğilim vardır. Hesaplanan 50. ağırlık ve boy yüzdelikleri Dünya Sağlık Örgütü (DSÖ) 2006 ve Neyzi 1978 aynı yüzdeliklerinden daha büyük bulunmuştur. Ayrıca hesaplanan 50. ağırlık ve boy yüzdelikleri, DSÖ yüzdelik değerlerine daha yakındır. SSoonnuuçç:: Bu çalışma, ağırlıklı olarak anne sütü ile beslenip Ankara’da yaşayan orta-yüksek sosyoekonomik düzeyden gelen, 0-2 yaş arasındaki bir grup Türk çocuğu için güncellenmiş ağırlık ve boy yüzdeliklerini ve eğrilerini sunmaktadır. Ancak, bu çalışmada elde edilen veriler bütün ülkeyi temsil edemeyeceği için, DSÖ’nün güncellenmiş büyüme eğrilerinin kullanılması daha uygun olabilir.
AAnnaahh ttaarr KKee llii mmee lleerr:: Ço cuk; bü yü me; bü yü me-ge liş me; ağır lık; boy de ği şik lik le ri TTuurrkkiiyyee KKlliinniikklleerrii JJ MMeedd SSccii 22000099;;2299((66))::11337766--8855
Cemil ÇOLAK,a
Aysu DUYAN ÇAMURDAN, MD,b Salih ERGÖÇEN, MD,c Atilla Halil ELHAN,a Figen ŞAHİN, MD,b
aDepartment of Statistics Fırat University, Elazığ
bDepartment of Social Pediatrics, Gazi University Faculty of Medicine,
cDepartment of Biostatistics Ankara University Faculty of Medicine, Ankara
Ge liş Ta ri hi/Re ce i ved: 01.07.2008 Ka bul Ta ri hi/Ac cep ted: 27.09.2008 Ya zış ma Ad re si/Cor res pon den ce:
Cemil ÇOLAK Fırat University
Department of Statistics, Elazığ TÜRKİYE/TURKEY
Cop yright © 2009 by Tür ki ye Kli nik le ri
Updated Weight and Height-for Age
Centiles in a Group of Predominantly
Breastfed Turkish Children Aged 0-2 Years
growth and de ve lop ment in a de ve lo ping so ci ety is a cru ci al is su e.1,2
One of the ma jor aims of au xo lo gi cal stu di es is to ob ta in re fe ren ce da ta to be used in the as sess - ment of growth in chil dren of si mi lar eth nic back- gro und. The growth charts on Tur kish chil dren pre sently in use in this co untry we re ba sed on me - a su re ments of Is tan bul chil dren of well-to-do fa m- i li es born in the ye ars 1950–1960. The se charts are the re fo re se lec ti ve and rep re sent we ight and he - ight va lu es of a gro up of chil dren from the hig her stra ta of the po pu la ti on.3
In Tur key, the per cen ti le growth cur ves for chil dren aged 0-18 ye ars, re por ted by Ney zi et al, are com monly used as growth stan dards ba sed on a samp le of he althy well-to-do chil dren.4Mo re re- cently, Ney zi et al cre a ted up-to-da te re fe ren ce stan dards for Tur kish chil dren and com pa red them with growth stan dards for US chil dren (CDC 2000 Growth Charts) and with pre vi o us lo cal da ta.3Gül- te kin et al com pa red he ight and we ight of scho ol chil dren aged bet we en 7-17 ye ars of low so ci o-eco - no mic back gro und with ava i lab le growth da ta from high so ci o-eco no mic stra ta.2Few stu di es on up-to- da te re fe ren ce stan dards for Tur kish chil dren aged 0-2 ye ars ha ve be en car ri ed out ba sed on the me di - u m– high so ci o-eco no mic le vel. The aim of this study was to up da te the growth stan dards of a gro - up of bre ast fed he althy in fants who we re lon gi tu - di nally fol lo wed up un til 24 months of age. In ad di ti on, we eva lu a ted 50th per cen ti le va lu es for he ight and we ight for the pre sent study, World He alth Or ga ni za ti on (WHO) mul ti cen ter growth stan dards, the WHO 2006 and the Tur kish stan- dards re por ted by Ney zi et al in 1978.4-6
MA TE RI AL AND MET HODS
This study was per for med bet we en 2002 and 2004 in the He althy Child Cli nic of Ga zi Uni ver sity Fac- ulty of Me di ci ne, An ka ra, Tur key. The study po pu - la ti on was usu ally from the me di u m- high so ci o- e co no mic sta tus in An ka ra. The study de sign was pros pec ti ve co hort. Et hi cal ap pro val was gran - ted by the Ga zi Uni ver sity Et hics Com mit te e, An - ka ra, Tur key. The fa mi li es of pa ti ents pro vi ded in for med con sent. The sub jects con sis ted of 466
chil dren (239 boys and 227 girls). The sing le ton, term in fants (38-42 we eks) with a birth we ight of 2500-4000 g, born in the ye ar of 2002 and fol lo - wed-up re gu larly for two ye ars in the cli nic we re inc lu ded in this study. Small for ges ta ti o nal age in- fants, in fants with chro nic di se a ses, and hos pi ta li zed in fants we re exc lu ded. All in fants we re se en by a pe di at ri ci an and a pe di at ric nur se on the 15thday of li fe and at 2, 4, 6, 9, 12, 18 and 24 months. On the - se vi sits, the ir fe e ding his to ri es, growth mo ni to ring (we ight, he ight, etc.), and im mu ni za ti on sche du le we re no ted in the stan dard forms pre pa red for this study. In ad di ti on, the stan dard forms inc lu ding de- mog rap hic cha rac te ris tics of the chil dren as well as all in for ma ti on re la ted to the chil dren we re re cor - ded in the com pu ter. We ight and he ight me a su re - ments we re per for med by a nur se wor king in the He althy Child Cli nic. For the in fants, re cum bent length was me a su red with a por tab le in fan to me ter;
we ight up to 18 kg was me a su red on a di gi tal sca le (Se ca, Vo gel&Hal ke, Ham burg, Ger many). The he - ight and we ight charts we re ba sed on 1700 he ight and we ight me a su re ments for boys, and 1576 he - ight and we ight me a su re ments for girls. The me an num ber of me a su re ments per boys and girls was 7.11 ± 1.31 and 6.94 ± 1.23, res pec ti vely.
STA TIS TI CAL ANALY SIS
He ight and we ight per cen ti le cur ves we re cons - truc ted by the LMS met hod, which was de ve lo ped by Co le in 1988. The LMS met hod is ba sed on the as sump ti on that da ta can be nor ma li zed by me ans of a po wer trans for ma ti on, stretc hing one ta il of the dis tri bu ti on and shrin king the ot her, the reby re mo ving any skew ness. LMS tech ni qu e is one of the most com monly used met hods for im pro ving re fe ren ce cen ti le cur ves. Box-Cox po wer, me an or me di an and co ef fi ci ent of va ri a ti on are the pa ra - me ters of the LMS tech ni qu e, res pec ti vely. A Box- Cox po wer trans for ma ti on app li ed to ob ta in the da ta is clo sely ap pro xi ma ted by a nor mal dis tri bu - ti on. In de ta il, the L cur ve is the smo ot hed cur ve of the Box-Cox po wer trans for ma ti on plot ted aga inst age; the M cur ve is the smo ot hed me di an of the me a su re ment plot ted aga inst age, and the S cur ve is the smo ot hed cur ve of the me a su re ment’s co ef fi ci - ent of va ri a ti on as it chan ges with age. The thre e
pa ra me ters of the met hod are es ti ma ted from the smo ot hed da ta cur ves.7-9In the pre sent study, the es ti ma ti on of L, M and S pa ra me ters was or ga ni zed at one-month age in ter vals se pa ra tely for boys and girls. The cur ves we re fit ted by ma xi mum pe na li - zed li ke li ho od to thre e smo ot hed cur ves: L(t) the Box-Cox po wer, M(t) the me di an and S(t) the co ef- fi ci ent of va ri a ti on. Cen ti le cur ves at age t can be ob ta i ned as C100α(t)= M(t)[1 + L(t)S(t)Zα]1/L(t), whe - re Zα is the nor mal equ i va lent de vi a te for ta il are - a α and C100α(t) is the cen ti le cor res pon ding to Zα. The 3rd, 10th, 25th, 50th, 75th, 90th, and 97thcen ti les we re es ti ma ted by using cal cu la ted L, M and S va l- u es for spe ci fic age po ints. Fit ting cur ves and smo - ot hing we re car ri ed out by the soft wa re prog ram lmsChart Ma ker Light v. 2.3. Stu dent’s t-test for in- de pen dent samp les was used to com pa re the me an we ight and he ight me a su re ments ac cor ding to gen- der. Re pe a ted me a su res we re analy zed by re pe a ted me a su res ANO VA. Mul tip le com pa ri sons we re do - ne with the Tu key test. p< 0.05 was con si de red sta- tis ti cally sig ni fi cant.
Demographic characteristic n %
Gender
Girl 227 49
Boy 239 51
Mother's education (years of schooling)
< 5 y 2 0.4
5-11 y 224 52.4
> 11 y 220 47.2
Father's education (years of schooling)
< 5 y - -
5-11 y 214 46
> 11 y 252 54
Mother's occupation
Housewife 210 45.1
Civil servant (teacher, doctor etc.) 218 46.8
Business owner 16 3.4
Other 22 4.7
Father's occupation
Civil servant (teacher, doctor etc.) 345 74
Workman 12 2.6
Business owner 81 17.4
Other 28 6
TABLE 1: Demographic characteristics of the children.
Month Height (cm) Weight (g)
Present WHO Neyzi Present WHO Neyzi
Boys
0 50.8 49.9 50.6 3411 3300 3400
1 54.9 54.7 - 4540 4500 -
3 62.1 61.4 60.5 6495 6400 5900
6 69.5 67.6 66.5 8350 7900 7800
9 74.1 72.0 71.0 9422 8900 9000
12 77.4 75.7 74.7 10.267 9600 10.000
15 80.6 79.1 78.0 11.023 10.300 10.800
18 83.7 82.3 81.5 11.711 10.900 11.500
24 90.0 87.8 84.0 12.959 12.200 12.650
Month Height (cm) Weight (g)
Present WHO Neyzi Present WHO Neyzi
Girls
0 50.4 49.1 50.2 3289 3200 3400
1 54.3 53.7 - 4285 4200 -
3 61.0 59.8 58.5 6037 5800 5400
6 68.1 65.7 64.5 7793 7300 7400
9 72.6 70.1 69.5 8873 8200 8600
12 76.0 74.0 73.0 9713 8900 9600
15 79.3 77.5 76.5 10.478 9600 10.400
18 82.6 80.7 79.5 11.205 10.200 11.000
24 89.2 86.4 85.5 12.605 11.500 12.200
TABLE 2: The 50thweight and height percentile values of the present study, WHO and Neyzi for boys and girls.
WHO, World Health Organization
WeightHeight BoysGirlsBoysGirls Age (month)LMSLMSLMSLMS 00.853411.050.120.473289.320.11-2.0150.810.041.3650.460.04 10.744540.670.120.414285.130.11-1.6054.910.041.1054.300.04 20.645592.480.120.365219.130.11-1.1758.740.040.8657.880.04 30.566495.930.110.316037.940.11-0.7262.130.040.6661.040.04 40.487245.400.110.286733.230.11-0.2665.040.040.4963.780.04 50.437854.730.110.257311.560.110.1767.480.040.3666.110.04 60.388350.360.110.237793.680.110.5669.540.040.2568.090.04 70.348760.790.110.228202.690.110.9171.270.040.1569.780.04 80.329110.310.110.228556.940.111.2072.750.040.0571.250.04 90.299422.130.110.228873.590.111.4474.050.04-0.0772.570.04 100.289715.900.110.239167.710.111.6275.230.04-0.2073.790.04 110.279996.950.110.239446.110.111.7476.330.04-0.3474.940.04 120.2610267.040.100.249713.520.111.8277.390.04-0.4876.060.04 130.2510527.710.100.249974.000.111.8678.450.04-0.6077.160.04 140.2510779.700.100.2410228.870.111.8679.510.04-0.6978.250.04 150.2511023.580.100.2510478.820.111.8480.570.04-0.7679.330.04 160.2511259.880.100.2510724.500.111.8181.620.04-0.8080.410.04 170.2611489.150.100.2610966.580.111.7882.680.04-0.8181.490.04 180.2511711.940.100.2711205.710.111.7683.730.04-0.8082.580.04 190.2511928.870.100.2711442.520.111.7784.780.04-0.7783.670.04 200.2512140.850.110.2811677.430.111.7985.830.04-0.7184.770.04 210.2412348.870.110.2911910.820.111.8386.870.04-0.6385.870.04 220.2312553.930.110.3012143.070.111.8987.920.04-0.5486.970.04 230.2212757.010.110.3212374.560.111.9588.960.04-0.4488.080.04 240.2112959.100.110.3312605.680.112.0290.010.04-0.3489.190.04
TABLE 3: The estimated LMS parameters for weight and height by age and gender.
BoysGirls Age (month)3102550759097SD3102550759097SD 02656.332893.653137.133411.053688.373940.714192.24559.732640.012838.633047.703289.323540.813775.634015.33501.30 13561.513866.764182.504540.674906.315241.565578.03734.963448.153703.203972.604285.134611.734917.885231.55650.03 24416.174780.125159.245592.486038.116449.556865.14892.634209.944516.414841.145219.135615.585988.526371.91788.01 35161.255571.686001.636495.937007.547482.697965.271022.074880.725231.165603.426037.946495.076926.357370.99907.65 45788.516234.386703.527245.407809.058335.018871.581123.785451.995839.126251.196733.237241.607722.378219.181008.55 56305.636778.037276.697854.738458.299023.589602.281201.625927.356344.886789.987311.567862.668384.798925.311092.64 66731.357223.767744.808350.368984.489580.0410191.381261.146322.456765.707238.737793.688380.788937.739514.991163.55 77086.907595.048133.638760.799418.9110038.2910675.361307.926655.407121.287618.738202.698820.909407.7610016.411224.93 87391.217912.378465.429110.319788.0410426.8411084.841346.236941.487427.797947.148556.949202.659815.7410451.741279.33 97662.898195.718761.629422.1310117.0210772.6911448.791379.837195.437700.638240.148873.599544.2910181.0710841.581328.86 107917.858462.079040.429715.9010427.0811098.6311791.631411.847430.347953.458512.019167.719861.8410520.7411204.071375.36 118160.178715.889306.669996.9510724.0911411.0712120.331443.317652.098192.388769.169446.1110162.5610842.4711547.411419.68 128390.938958.419561.8210267.0411010.1011712.3212437.541474.817864.758421.659016.069713.5210451.4911151.6411877.381462.44 138611.139190.819807.2410527.7111286.9112004.4512745.571506.818071.818644.929256.519974.0010732.9611452.8612198.891504.16 148821.439413.7510043.5810779.7011555.3812288.4713045.631539.528274.438863.409491.8110228.8711008.3711747.5712513.431544.96 159022.449627.7710271.4011023.5811816.1212565.0913338.611573.048473.169077.709722.5910478.8211278.3912036.4412821.631584.86 169214.799833.4510491.2111259.8812069.7412835.0513625.391607.458668.579288.439949.5010724.5011543.6812320.1013124.081623.88 179399.1710031.3810703.5811489.1512316.8413099.0213906.801642.828861.219496.1810173.1710966.5811804.9112599.1913421.391662.04 189576.3110222.2110909.0811711.9412558.0213357.7114183.711679.189051.649701.5710394.2511205.7112062.7312874.3413714.121699.33 199747.0110406.6311108.3411928.8712793.9013611.8314456.971716.569240.379905.1510613.3311442.5212317.7613146.1714002.871735.80 209912.2310585.6011302.3112140.8513025.4013862.2414727.401754.909427.7010107.2610830.7911677.4312570.4913415.2114288.221771.53 2110072.9910760.1511492.0112348.8713253.4414109.8314995.811794.139613.9210308.2111046.9711910.8212821.3513681.9814570.791806.66 2210230.3210931.3011678.4512553.9313478.9514355.4515262.941834.159799.2810508.2911262.1812143.0713070.8113947.0114851.221841.32 2310385.2611100.1111862.6812757.0113702.8614599.9215529.511874.839984.0610707.7711476.7512374.5613319.3314210.8615130.161875.65 2410538.8611267.6312045.7112959.1013926.0714844.0515796.201916.0410168.5110906.9511691.0012605.6813567.3514474.0715408.281909.80
TABLE 4: Predicted percentile values of weight for Turkish children aged 0-2 years.
BoysGirls Age (month)3102550759097SD3102550759097SD 047.1248.2049.3950.8152.3653.8855.523.0646.5547.8149.0750.4651.8453.0654.262.81 150.9752.1453.4154.9156.5358.1059.763.2050.2351.5352.8554.3055.7557.0658.342.95 254.5755.8357.1758.7460.4262.0163.683.3253.6855.0156.3657.8859.3960.7662.123.08 357.7559.0960.4962.1363.8465.4567.113.4156.7458.1059.4961.0462.6164.0365.453.17 460.4961.9063.3665.0466.7768.3870.023.4759.4060.7862.1963.7865.3966.8568.323.25 562.8164.2765.7867.4869.2370.8372.453.5161.6763.0664.4966.1167.7569.2570.753.31 664.7566.2667.8069.5471.2972.8874.473.5463.5965.0066.4568.0969.7671.2872.823.36 766.3967.9469.5271.2773.0374.6176.183.5765.2466.6668.1269.7871.4773.0374.593.41 867.7869.3770.9872.7574.5276.1077.653.6066.6768.1069.5871.2572.9774.5576.143.45 969.0070.6272.2574.0575.8277.4178.953.6367.9369.3870.8772.5774.3175.9277.553.50 1070.0971.7573.4175.2377.0278.6180.163.6769.1070.5572.0673.7975.5677.2178.873.56 1171.1072.7974.4876.3378.1479.7581.313.7270.1971.6673.1974.9476.7578.4480.143.63 1272.0673.7975.5277.3979.2380.8682.443.7871.2272.7174.2776.0677.9179.6481.403.71 1373.0174.7876.5478.4580.3381.9883.593.8572.2373.7475.3377.1679.0680.8382.653.80 1473.9575.7677.5679.5181.4283.1184.753.9473.2174.7576.3778.2580.2082.0283.903.89 1574.8876.7378.5780.5782.5384.2685.944.0374.1775.7577.4179.3381.3483.2285.164.00 1675.8077.7079.5881.6283.6385.4087.134.1275.1176.7378.4380.4182.4884.4286.424.12 1776.7278.6580.5882.6884.7486.5588.324.2376.0577.7179.4681.4983.6285.6287.694.24 1877.6279.6181.5883.7385.8487.7089.524.3376.9778.6880.4982.5884.7786.8388.964.37 1978.5280.5582.5884.7886.9488.8590.714.4477.9079.6681.5183.6785.9288.0590.244.50 2079.4081.4983.5785.8388.0489.9991.894.5578.8280.6382.5584.7787.0989.2791.524.63 2180.2882.4384.5686.8789.1491.1493.074.6679.7481.6183.5885.8788.2690.5092.814.76 2281.1583.3685.5587.9290.2392.2794.254.7780.6582.5884.6286.9789.4391.7394.094.90 2382.0284.2986.5388.9691.3393.4195.424.8881.5683.5685.6688.0890.6092.9695.385.04 2482.8885.2287.5290.0192.4294.5596.604.9982.4684.5386.6989.1991.7894.2096.675.18
TABLE 5: Predicted percentile values of height for Turkish children aged 0-2 years.
RE SULTS
De mog rap hic cha rac te ris tics of the chil dren we re gi ven in Tab le 1. Me an ages of mot hers and fat hers we re 28.9 ± 5.05 ye ars and 33.1 ± 5.24 ye ars, res - pec ti vely. In the first 4 months, exc lu si vely bre ast- fe e ding (EBF) ra te was 53.7%. No ne of the in fants was fed with for mu la alo ne. Comp le men tary fo ods we re star ted at a me an ti me of 4.4 ± 2.8 months. The in fants we re still fed with bre ast milk in ad di ti on to comp le men tary fo ods with a ra te of 86% at 6 months, 66% at 12 months, and 22% at 24 months.
The 50thwe ight and he ight per cen ti le va lu es of the pre sent study, WHO and Ney zi for boys and girls we re shown in Tab le 2. In boys and girls, the es ti ma ted 50thper cen ti le va lu es of he ight and we - ight we re mostly hig her than the 50thper cen ti le va - lu es of WHO and Ney zi, and the 50thhe ight and we ight per cen ti le va lu es of the pre sent study we re clo ser to tho se of WHO than tho se of Ney zi.
The es ti ma ted LMS pa ra me ters for he ight and we ight by age and gen der we re pre sen ted in Tab le 3. The se pa ra me ters we re used to ob ta in the re qu - i red cen ti les for each gen der. Pre dic ted per cen ti le va lu es of we ight and he ight for chil dren aged 0-2 ye ars we re gi ven in Tab les 4 and 5, res pec ti vely.
As can be se en in Tab le 3, the es ti ma ted M pa- ra me ters for we ight and he ight in boys we re hig her than the pa ra me ters in girls for each month. Me an we ight and he ight me a su re ments for boys we re sig- ni fi cantly hig her than tho se for girls on the 15thday of li fe and at 2, 4, 6, 9, 12, 18 and 24 months ba sed on the re sults of the Stu dent’s t-test (p< 0.05). The -
re fo re, per cen ti le cur ves for girls and boys we re plot ted se pa ra tely. The hig hest M pa ra me ters for we ight and he ight we re de ter mi ned at 24 months.
When the re pe a ted me a su res for we ight and he ight we re analy zed, boys and girls se e med to ha ve dif- fe rent we ight and he ight le vels (p< 0.05). The cor- re la ti on bet we en ti me and gen der was not sta tis ti cally sig ni fi cant (p> 0.05).
Fi gu res 1 and 2 de pict we ight per cen ti le cur ves es ti ma ted from the LMS pa ra me ters. He ight per cen - ti le cur ves de ri ved from LMS pa ra me ters we re des - cri bed in Fi gu res 3 and 4. In both he ight and we ight per cen ti le cur ves, the re ap pe a red a ste ady up ward trend un til 24 months of age for each gen der.
Fi gu res 5-8 de mons tra te the 50thwe ight and he ight per cen ti le cur ves of this study, Ney zi and WHO stan dards for both gen ders. As se en in the se fi gu res, the 50thwe ight and he ight per cen ti le cur - ves fo und in this study we re hig her than the cur ves of WHO and Ney zi.
DIS CUS SI ON
The per cen ti les of we ight and he ight chan ge mar - kedly from one co untry to anot her and from one city to anot her, par ti cu larly in child ho od. The re - fo re, co un tri es ha ve to cre a te, re vi se or im pro ve the ir own we ight and he ight cen ti les pe ri o di cally for the as sess ment of in di vi du al growth.10,11In ad- di ti on, growth stan dards sho uld be up da ted ac cor - ding to study de sign, so ci o -e co no mic sta tus, cer ta in ages, type of fe e ding, gen ders etc. for mo re ac cu ra - te growth eva lu a ti on. The pre sent study im pro ves and up da tes the we ight and he ight cen ti les for a
FIGURE 1: Weight percentile curves for boys. FIGURE 2: Weight percentile curves for girls.
FIGURE 3: Height percentile curves for boys. FIGURE 4: Height percentile curves for girls.
gro up of 0-2 ye ars old chil dren from the me di u m- high so ci o- e co no mic sta tus in An ka ra, Tur key, who we re pre do mi nantly bre ast fed.
The we ight and he ight 50thper cen ti le va lu es of he althy in fants inc lu ded in our study we re hig - her than the va lu es de ter mi ned in pre vi o us Tur k-
FIGURE 5: The 50thweight percentile values of the present study, WHO and Neyzi for boys.
FIGURE 6: The 50thweight percentile values of the present study, WHO and Neyzi for girls
FIGURE 7: The 50thheight percentile values of the present study, WHO and
Neyzi for boys FIGURE 8: The 50thheight percentile values of the present study, WHO and
Neyzi for girls.
