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German height references for children aged 0 to under 18 years compared to WHO and CDC growth charts

Aim: The objective is to present height-for-age percentiles representative for infants, children, and adolescents in Germany and to compare them with older German height references by Kromeyer-Hauschild which are based on heterogeneous pooled data (KH) and with international growth charts from the Centers for Disease Control (CDC) as well as the growth standard and the growth reference of the World Health Organization (WHO). Subjects and methods: The reference population consists of a nationally representative sample of 17 079 children and adolescents aged 0–17 years (KiGGS study 2003–2006) with standardized height measurements. Height reference curves were created using Cole's LMS method. To compare KiGGS with other reference systems, KiGGS height values were transformed to SD-scores using the KH, WHO and CDC references. Results: Height-for-age percentiles in KiGGS increase until age 16 years in girls and until the end of the observed age range (17.98 years) for boys. In general, boys are taller than girls, except for the age range 10.5–13.0 years. The difference in height between boys and girls is negligible before puberty and reaches 13 cm at age 17.98 years. KiGGS and KH percentiles differ only slightly. However, there are substantial differences in SD-score levels between KiGGS on the one hand and WHO and CDC on the other hand, KiGGS generally being higher, especially in the extreme percentiles. Conclusion: The KiGGS height-for-age references can be recommended as a national height reference for screening and monitoring growth in infants (starting from 4 months of age), children and adolescents in Germany. In German samples, the WHO and CDC references can be used for international comparisons.