Overview
Growth charts display patient measurements over time compared to WHO reference populations. The system supports four chart types, each showing standard deviation (SD) curves and patient data points.Available growth charts
Weight-for-age
Tracks weight gain from birth to 60 months
Height-for-age
Monitors linear growth and stature development
BMI-for-age
Assesses body mass index changes over time
Head circumference-for-age
Evaluates head growth from birth to 36 months
Accessing growth charts
Growth charts are integrated into the somatometry view:Select a patient
Choose the pediatric patient whose growth you want to review. The patient must have at least one somatometry record.
Navigate to chart tabs
Click on the desired chart tab:
- Peso/Edad: Weight-for-age
- Talla/Edad: Height-for-age
- IMC/Edad: BMI-for-age
- P. Cefálico/Edad: Head circumference-for-age
Charts automatically load gender-specific WHO data from the database (tables:
tcSomatometriasPesoEdad, tcSomatometriasAlturaEdad, tcSomatometriasBmiEdad, tcSomatometriasCircuHeadAge).Understanding WHO percentile curves
Each growth chart displays five standard deviation curves representing population percentiles:Curve interpretation
| Curve | Label | Color | Interpretation |
|---|---|---|---|
| +3 SD | P97 | Black (bold) | 97th percentile - upper limit |
| +2 SD | P85 | Red | 85th percentile - overweight threshold |
| Median | P50 | Green | 50th percentile - population average |
| -2 SD | P15 | Red | 15th percentile - underweight threshold |
| -3 SD | P3 | Black (bold) | 3rd percentile - lower limit |
WHO uses standard deviations (SD) rather than traditional percentiles. The curves represent statistical boundaries for normal growth variation.
Weight-for-age chart
Tracks body weight from birth to 5 years (0-60 months).Chart specifications
- X-axis: Age in months (0-60)
- Y-axis: Weight in kilograms (2-28 kg)
- Gender-specific: Separate curves for boys (blue background) and girls (pink background)
- Data source:
tcSomatometriasPesoEdadtable
Clinical interpretation
- Below P3: Severe underweight - requires immediate assessment
- P3-P15: Underweight - monitor closely and consider intervention
- P15-P85: Normal weight range
- P85-P97: Overweight - nutritional counseling recommended
- Above P97: Severe overweight - comprehensive assessment needed
Height-for-age chart
Monitors linear growth and stature development.Chart specifications
- X-axis: Age in months (0-60)
- Y-axis: Height/length in centimeters
- Gender-specific: Boys and girls have different growth patterns
- Data source:
tcSomatometriasAlturaEdadtable
Clinical interpretation
- Below P3: Short stature - evaluate for growth disorders
- P3-P15: Below average height - monitor trend
- P15-P85: Normal height range
- P85-P97: Above average height
- Above P97: Tall stature - typically normal variant
For children under 24 months, length is typically measured lying down (recumbent length). For children 24 months and older, standing height is measured.
BMI-for-age chart
Assesses body mass index changes from 0-60 months.Chart specifications
- X-axis: Age in months (0-60)
- Y-axis: BMI in kg/m² (12-22)
- Gender-specific: Different patterns for boys and girls
- Data source:
tcSomatometriasBmiEdadtable
Clinical interpretation
| BMI Position | Classification | Action Required |
|---|---|---|
| Below P15 | Underweight | Nutritional assessment |
| P15-P85 | Healthy weight | Maintain current habits |
| P85-P97 | Overweight | Dietary counseling |
| Above P97 | Obesity | Comprehensive intervention |
Head circumference-for-age chart
Evaluates brain growth and development from birth to 36 months.Chart specifications
- X-axis: Age in months (0-36)
- Y-axis: Head circumference in centimeters
- Gender-specific: Boys typically have larger head circumference
- Data source:
tcSomatometriasCircuHeadAgetable
Clinical interpretation
- Below P3: Microcephaly - neurological evaluation indicated
- P3-P15: Small head - monitor for crossing percentiles
- P15-P85: Normal head circumference
- P85-P97: Large head - typically familial
- Above P97: Macrocephaly - assess for hydrocephalus
Head circumference measurement is most critical during the first 24 months when brain growth is most rapid.
Chart features
Interactive elements
- Hover tooltips: Display exact values and age when hovering over data points
- Age formatting: Shows age as “Years + Months” (e.g., “2a 6m”)
- Grid lines: Major gridlines every 6 months (X-axis) and at key intervals (Y-axis)
- Legend: Positioned at top-right for easy reference
Visual customization
- Patient data points are displayed in the primary theme color
- Points are larger (9px radius) for easy visibility
- Lines connect sequential measurements showing growth trajectory
- Charts use 70% viewport height for optimal viewing
Data presentation
Below each chart:- WHO standards reference: Confirms data source
- Data point count: Shows number of WHO reference points loaded
- Status indicator: Displays loading/error/success state
Growth analysis
Identifying growth patterns
Check position
Note which percentile curve the patient follows. Most healthy children track consistently along one percentile.
Watch for crossing
Crossing two or more major percentile lines (upward or downward) may indicate a growth issue requiring evaluation.
Red flags requiring evaluation
- Falling across two or more percentile curves
- Rising rapidly across percentiles (weight-for-age or BMI)
- Head circumference crossing percentiles
- Any measurement below P3 or above P97
- Discordance between weight and height percentiles
Technical implementation
Data loading
The system loads WHO data on patient selection:- Determines patient gender (M/F) from patient record
- Queries gender-specific WHO tables via
somatometryService.getWHOChartData() - Retrieves complete percentile datasets (ages 0-60 months)
- Caches data to prevent repeated database queries
Fallback mechanism
If the database lacks WHO data, the system uses hardcoded reference values to ensure charts remain functional.Charts are rendered using Chart.js library with responsive design for various screen sizes.
Patient data plotting
The system plots patient measurements by:- Extracting all somatometry records for the selected patient
- Calculating age in months for each measurement date
- Sorting records chronologically
- Plotting points on the appropriate chart
- Connecting points with lines to show growth trajectory
Chart display rules
- Charts only display when at least one somatometry record exists
- Empty state message appears if no data is available
- Loading spinner shows while WHO data is being fetched
- Error messages display if database queries fail
Printing and sharing
Growth charts can be:- Printed directly from the browser
- Included in medical records
- Shared with specialists for consultation
- Used for parent education
Always review growth charts in the context of the complete clinical picture, including family history, nutrition, and overall health.
Best practices
Multiple measurements
Use at least 3-4 data points over time to establish a reliable growth pattern.
Compare all charts
Review weight, height, BMI, and head circumference together for comprehensive assessment.
Related features
- Somatometry measurements: Record growth measurements
- Development tracking: Monitor developmental milestones