A new Swedish reference for total and prepubertal height

Aim We aimed to develop up-to-date references with standard deviation scores (SDS) for prepubertal and total height. Methods Longitudinal length/height measures from 1572 healthy children (51.5% boys) born at term in 1989-1991 to non-smoking mothers and Nordic parents were obtained from the GrowUp 1990 Gothenburg cohort. A total height SDS reference from birth to adult height was constructed from Quadratic-Exponential-Pubertal-Stop (QEPS) function estimated heights based on individual growth curves. A prepubertal height SDS reference, showing growth trajectory in the absence of puberty, was constructed using the QE functions. Results The total height reference showed taller prepubertal mean heights (for boys 1-2 cm; for girls 0.5-1.0 cm) with a narrower normal within +/- 2SDS range vs the GrowUp 1974 Gothenburg reference. Adult height was increased by + 0.9 cm for women (168.6 cm) and by + 1.6 cm for men (182.0 cm). Height in children growing at -2SDS (the cut-off used for referrals) differed up to 2 cm vs the GrowUp 1974 Gothenburg reference, 3 cm vs Swedish 1981 references and World Health Organisation (WHO) 0-5 years standard, and 6-8 cm vs the WHO 5-19 years reference. Conclusion Up-to-date total and prepubertal height references offer promise of improved growth monitoring compared with the references used in Sweden today.