Development of Regional Anthropometric Norms and Growth Percentiles for Children and Adolescents in Khairpur Mir’s Sindh, Pakistan

Abstract

Background: Anthropometric assessment using height, weight, and body mass index (BMI) is essential for evaluating growth patterns and nutritional status in children and adolescents. However, international growth references may not fully reflect regional variations in body size, maturation, and population-specific growth trajectories. Objective: This study aimed to describe age- and sex-specific empirical anthropometric percentile distributions for children and adolescents in Khairpur Mir’s, Sindh, Pakistan, and to assess the prevalence of BMI-based nutritional categories within this population. Methods: A cross-sectional survey was conducted between March and May 2025 among school-aged participants from public and private schools as well as Madrassas in Khairpur Mir’s. Children and adolescents aged 7–18 years were recruited using a multistage sampling approach. Standardized procedures were used to measure stature (cm), weight (kg), and circumferences, and BMI was calculated as weight/height² (kg/m²). Age- and sex-stratified percentiles (P3–P97) for height and weight were computed as empirical quantiles within each completed-year age group. BMI categories (underweight, normal weight, overweight, obesity) were assigned using percentile-based thresholds; therefore, findings are descriptive and not based on smoothed WHO BMI-for-age Z-score modeling. Results: A total of 1,000 participants were included (55.0% girls, 45.0% boys), with a mean age of 12.96 ± 2.8 years. The overall mean height and weight were 146.92 ± 15.84 cm and 41.20 ± 15.69 kg, respectively. Most participants were classified within the normal BMI range (79.2%), while 9.2% were overweight, 6.4% obese, and 5.2% underweight. Growth patterns demonstrated expected age-related increases in height and weight, with girls showing relatively higher height values in early adolescence and boys surpassing girls in later adolescent years. Conclusion: This study provides local empirical percentile distributions for height and weight among children and adolescents in Khairpur Mir’s, offering baseline descriptive growth information for regional screening and comparison. However, these findings should not be interpreted as national reference standards, as formal growth chart development requires smoothed modeling, age-in-month precision, and broader multi-site representativeness. Future studies should expand across Pakistan and apply standardized growth-reference methodologies to establish comprehensive pediatric anthropometric norms.