Growth evaluation is an important tool to learn more about health. After years of study, the World Health Organization (WHO) launched a new Growth Curve, an international standard developed to analyze the normality or not of the child growth process, as well as compose the diagnosis of nutritional status and monitor its evolution over time.

With the Ninsaúde Apolo system, pediatricians will be able to analyze these data of children from zero to five years old, through the growth curve existing within the system itself. To use this tool is very simple, check out the step by step below.

Creating a form template

First, before using the growth curve graph, it is necessary to fill the patient's chart with data that will generate the information in the graph. For that, we will use a form. Within the system, there is an area where you can create form templates, and some ready-made templates are made available by the software itself, simply by downloading it to your account.

In this case, it will be necessary to download the "Growth curve" form. Observe in the example below how to download:

Collecting patient data

On the growth curve, three important information about the patient must be constantly updated: weight, length, and head circumference. This information must be entered in the form mentioned above. See how simple it is to use it:

Viewing information on the growth curve

To use the growth curve tool, this tab must be active on the attendance screen. To do this, just click on the + icon that gives access to the medical record settings, activates the corresponding option, and save.

Done that, just access the growth curve tab and select the form that was filled in with the patient's data. For the graph to work, it is important to make sure that other data such as the child's date of birth and sex are filled in your registration form, as this is essential information to form the graph, and without them, it will not be possible to use it.

Since boys and girls have different growth patterns, the curves are different. The goal is that problems such as malnutrition, overweight, obesity, and other conditions associated with the child's growth and nutrition can be detected and addressed early.

Note that the blue dot on the charts is equivalent to the information entered on the form. At each new appointment, the health professional must insert a new form in the attendance and fill it with the updated data of the patient, so that he can follow his evolution.

More information

  • Note that when hovering the mouse over the lines, the system gives you information about which weight/length/head circumference was informed in that period (located by the blue dot).
  • In the same place, there is information about which month of the child's life corresponds to that data. In the example above, the patient is in her second month of life (month 2) with a weight of 6.5 kg.
  • Below, you can adjust the period being viewed.  In the example above, the graph shows information generated over the next 8 months of the child's life, which can be adjusted in the future to show the evolution in other periods.
  • In addition to the growth curve, below it, the system also shows us in a simple graph the form's responses with their respective dates when they were entered in the medical record.

Score-Z or percentile: which one to use?

Score-Z and percentile are scales used in anthropometric assessments of children and adolescents to investigate situations of normality or nutritional risk (weight and height inappropriate for sex and age). To use them, it is necessary to know the objective of the evaluation so that there is no confusion and errors in the nutritional diagnosis.

The Z-Score is an estimator that quantifies the distance between an observed value and the median of a population. The Z-score measures are more specific, that is, the more accurately detect those cases that are most severely related to situations of nutritional risk.

Percentile measurements tend to be more comprehensive. In other words, children classified as nutritional risk from the percentile may only be close to a risk situation, but not necessarily at nutritional risk.

For example, imagine that the WHO has mapped the weight of 100 boys, from the lightest to the heaviest, and plotted the weight of these babies on a graph. From them, intermediate rules were established, which are called percentiles. If a baby is in the 85th percentile concerning weight and height, it means that he is bigger and heavier than 85% of babies his age. This does not mean, however, that he is healthier than a baby in the 15th percentile. Most importantly, the baby has an upward line of growth, regardless of the percentile.

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