Head growth charts can give wrong impression

I always wondered why our pediatrician measured our daughters’ heads during regular office visits as babies, but since there was never a concern I didn’t bother to ask.

Turns out babies whose heads are too big or too small or grow too fast could have problems that require medical intervention. Yes, yes, I know that seems pretty obvious in hindsight.


But a study out of Children’s Hospital of Philadelphia reports that the growth charts that pediatricians rely upon to check those head-circumference measurements could be off, leading to unnecessary testing, costs and parental anxiety. The CHOP researchers reviewed electronic medical records of 75,412 children in their hospital’s primary care network in Pennsylvania, New Jersey and Delaware.

They found that the head growth curves by the Centers for Disease Control and Prevention as well as for the World Health Organization put significantly larger-than-expected numbers of these babies above or below the normal ranges. The study was published online in the journal Pediatrics Monday morning.

The Researchers concluded that the resulting misclassifications could delay diagnosis of some children while leading to the overdiagnosis of other healthy children.

“More research is … needed to determine how doctors can use head circumference growth curves to identify children with problems without causing unnecessary worry to parents of healthy children,” said David Rubin, the study’s senior author and a pediatric researcher at CHOP.

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