Comparison of WHO and CDC growth charts in predicting pulmonary outcomes in cystic fibrosis

Evans Machogu, Yumei Cao, Tami Miller, Pippa Simpson, Hara Levy, Diana Quintero, Praveen S. Goday*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Objectives: The relation of weight-for-length (WFL) and weight-for-age (WFA) measurements with pulmonary function in patients with cystic fibrosis (CF) using the World Health Organization (WHO) growth standards has not been evaluated. The objective of the present study was to show that the relation of WFL and WFA measurements at 2 years with forced expiratory volume in 1 second (FEV1) at 6 to 8 years differs when using theWHO versus the Centers for Disease Control and Prevention (CDC) growth charts. Methods: We assessed 1155 patients in the CF Foundation Patient Registry born between 2001 and 2004. Comparisons were made between the CDC and WHO growth charts. Results: The WFL percentiles are significantly higher for the WHO growth standards compared with those for the CDC growth charts (median and interquartile range [IQR] WHO-64.8 [41.7-84.9], CDC-48.1 [23.7-75.7], P<0.0001). WFL and WFA percentiles at 2 years on both charts are strongly associated with FEV1 at 6 to 8 years of age. The FEV1 at 6 to 8 yearswas statistically significantly lower for children who were classified as reaching aWFL≥50th percentile at 2 years byWHOstandards alone versus those who qualified by both growth charts (median and IQR 103 [94-115] vs 107 [96-117], P<0.05). Continued weight gain between 2 and 6 years was associated with a higher lung function at age 6 to 8 years. Conclusions: Although children attaining the 50th WFL percentile on the WHOgrowth chart by age 2 years have a lower FEV1 at 6 years than children attaining the same percentile on the CDC chart, both groups of children attain clinically normal FEV1. Further studies are needed to determine whether this difference is clinically meaningful.

Original languageEnglish (US)
Pages (from-to)378-383
Number of pages6
JournalJournal of pediatric gastroenterology and nutrition
Issue number3
StatePublished - Mar 7 2015


  • CDC
  • FEV1
  • WHO
  • nutrition
  • pulmonary function

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

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