New growth references for assessment of stature and skeletal maturation in Australians

Background: We have provided evidence of secular increases in stature and acceleration of skeletal maturation in Australian male children and young adults in recent decades, and relatively less prominent secular increases in stature in females. Aims: Our aims were to construct new references for stature and skeletal age in Australians. Methods: We conducted a cross-sectional study of 2,497 South Australians, comprising 1,255 males and 1,242 females aged between 9 and 18 years. Clinical records obtained from 1995 to 2005 comprised stature, chronological and skeletal ages of these individuals. Means and standard deviations for stature and skeletal age were visually smoothed for each sex to construct growth charts depicting the 97th, 90th, 75th, 50th, 25th, 10th and 3rd centiles. Results: Comparisons of the new stature references with the NHMRC (1975) charts indicated an upward shift of stature centiles across all age groups in both sexes by around 4-5 cm. Generally, skeletally advanced individuals tended to be taller, and skeletally delayed individuals tended to be shorter compared with the total sample in younger age groups, but this was less apparent in older age groups. Males aged 9 years in our study were skeletally advanced, on average, by 0.4 years, whereas males aged 17 years were skeletally delayed, on average, by 0.3 years compared with the Greulich and Pyle (1959) standards. In contrast, skeletal and chronological ages were concordant in females. Conclusion:Our new references for stature and skeletal age provide up-to-date information for orthodontists, paedodontists and paediatricians requiring growth data for young Australians