What are the weight percentile, height percentile, BMI, and BMI centile for a 7-year-old female patient with a weight of 20.5 kg and a height of 107.2 cm according to the UK WHO (World Health Organization) growth chart?

Growth Assessment for 7-Year-Old Female

Direct Answer

This 7-year-old girl has severely compromised growth with weight at approximately the 2nd percentile, height well below the 2nd percentile (likely <0.4th percentile), and a BMI of 17.8 kg/m² at approximately the 25th-50th percentile, indicating she requires immediate comprehensive medical evaluation for underlying causes of growth failure. 1

Growth Parameters Calculated

Weight Percentile

• Weight: 20.5 kg at age 7 years = approximately 2nd percentile 1
• This falls at the critical threshold where the WHO and CDC recommend evaluation for potential underlying causes 1, 2

Height Percentile

• Height: 107.2 cm at age 7 years = well below the 2nd percentile (likely <0.4th percentile) 1
• For reference, the 2nd percentile for a 7-year-old girl is approximately 113-114 cm 2
• This represents severe short stature requiring urgent investigation 1

BMI Calculation and Percentile

• BMI = 20.5 kg ÷ (1.072 m)² = 17.8 kg/m² 3
• BMI percentile: approximately 25th-50th percentile 3
• This indicates that while her absolute weight and height are both severely low, her weight is relatively proportionate to her height 3

Clinical Significance and Urgent Actions Required

Why This Child Needs Immediate Evaluation

• Both weight and height below the 2nd percentile indicate potential chronic malnutrition, underlying medical conditions, or genetic factors affecting growth 1
• The WHO specifically recommends that children with measurements below 2 standard deviations (2.3rd percentile, labeled as 2nd percentile) should be evaluated for adverse health conditions 1, 2
• The severely low height (<0.4th percentile) is particularly concerning and may indicate chronic disease, malabsorption, celiac disease, inflammatory bowel disease, or endocrine disorders 1

Recommended Evaluation Steps

Immediate referral to pediatric specialist is warranted 1:

• Comprehensive nutritional assessment: Evaluate current dietary intake, caloric adequacy, food allergies/intolerances, and feeding behaviors 1
• Screen for chronic conditions: Consider celiac disease, inflammatory bowel disease, and malabsorption syndromes given the severe height deficit 1
• Endocrine evaluation: Screen for growth hormone deficiency, thyroid disorders, and other endocrine causes of growth failure 1
• Genetic assessment: Evaluate for genetic conditions or syndromes (e.g., Turner syndrome) that can cause poor growth 1
• Family growth patterns: Assess parental heights to determine if low stature reflects genetic potential, though the severity here suggests pathology 1

Monitoring Strategy

• Serial measurements every 3 months are recommended for children with concerning growth trajectories to quickly detect true growth decline 1
• Growth velocity (rate of growth over time) is more informative than single measurements and must be tracked 1
• All measurements should be plotted on UK WHO growth charts (CDC charts for children ≥24 months) to visualize trends 1, 2

Critical Pitfalls to Avoid

• Do not reassure parents that this is "normal variation" - measurements this far below the 2nd percentile, especially for height, indicate likely pathology 1
• Do not delay evaluation - intervention should occur before reaching the 2nd percentile when downward trajectory is clear, and this child is already well below that threshold 1
• Do not assume familial short stature without proper evaluation - the severity of growth restriction here warrants full workup regardless of parental heights 1

Long-term Prognosis Context

• Research indicates that approximately 31.6% of boys and 28.4% of girls who are short at age 7 remain short as adults, even without identifiable pathology 4
• However, this child's measurements are more severe than the 5th percentile studied in that research, making pathological causes more likely 4