Accuracy of head circumference measurement: an analysis using different measuring tapes
DOI:
https://doi.org/10.1590/1980-0037.2025v27e105314Keywords:
anthropometry, child development, growth, newborn, pediatricsAbstract
The aim of this study was to determine the accuracy of measuring tapes and head circumference measurements, analyzing four commercial measuring tapes available on the market. The research included technical analysis of four measuring tape models in the laboratory and their practical application on a training mannequin. Each tape was measured 10 times at two intervals with a calibrated digital caliper in the laboratory. The absolute and relative technical error of measurement (TEM) was calculated, considering deviations between measurements and true values. Tape 3 had the highest TEM, while tape 4 stood out for greater accuracy. The practical application had a training workshop with 25 students. Each participant measured the head circumference three times with each tape and compared them to a standard evaluator’s measurements. Tapes 2 and 4 had more accurate results, while tapes 1 and 3 had greater TEM. Regarding usability, tape 3 was the most difficult to handle, while tapes 1 and 4 were more practical (although tape 1 was considered long), and tape 3 was difficult to fit. It is crucial to standardize measuring tapes and techniques to ensure accurate and consistent measurements. It is recommended to use tapes made of non-stretchable material and to respect the usage time. It is also essential to train professionals constantly for multidisciplinary monitoring, ensuring accurate measures and the effective use of Personal Child Health Records to monitor child growth.
References
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. Política Nacional de Atenção Integral à Saúde da Criança: orientações para implementação / Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. – Brasília: Ministério da Saúde, 2018.
Jezus S V, Pereira BCSN, Bastida FF, Masochini RG, Cunha AN. Influences and interferences in child growth and development. Sci Electron Arch 2018;11:93–8. https://doi.org/10.36560/1142018619.
Lamb MM, Connery AK, Colbert AM, Bauer D, Olson D, Paniagua-Avila A, et al. Anthropometric proxies for child neurodevelopment in low-resource settings: length- or height-for-age, head circumference or both? J Dev Orig Health Dis 2023;14:61–9. https://doi.org/10.1017/S2040174422000423.
Connery AK, Lamb MM, Colbert AM, Bauer D, Olson D, Paniagua-Avila A, et al. A prospective cohort study of head circumference and its association with neurodevelopmental outcomes in infants and young children in rural Guatemala. J Dev Orig Health Dis 2022;13:779–86. https://doi.org/10.1017/S204017442200023X.
Sociedade Brasileira de Pediatria. Departamento Científico de Nutrologia. Manual de avaliação nutricional. 2ª ed. atualizada. São Paulo: SBP; 2021. 120 p. Weffort VRS, Maranhão HS, Mello ED, Barretto JR, Fisberg M, Moretzsohn MA, Wayhs MLC, Konstantyner T.
Victora CG, Schuler-Faccini L, Matijasevich A, Ribeiro E, Pessoa A, Barros FC. Microcephaly in Brazil: How to interpret reported numbers? Lancet 2016;387:621–4. https://doi.org/10.1016/S0140-6736(16)00273-7.
Davies HE, Wathen CG, Gleeson F V. The risks of radiation exposure related to diagnostic imaging and how to minimise them. BMJ 2011;342:d947–d947. https://doi.org/10.1136/bmj.d947.
Silva DAS, Pelegrini A, Pires-Neto CS, Vieira MFS, Petroski EL. O antropometrista na busca de dados mais confiáveis. Rev Bras Cineantropometria e Desempenho Hum 2010;13:82–5. https://doi.org/10.5007/1980-0037.2011v13n1p82.
Brasil. Ministério da Saúde. Secretaria de Atenção Primária à Saúde. Departamento de Gestão do Cuidado Integral. Coordenação-Geral de Articulação do Cuidado Integral. Coordenação de Atenção à Saúde da Criança e do Adolescente. Caderneta da Criança: passaporte da cidadania. 6ª ed. Brasília: Ministério da Saúde; 2023.
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Orientações para a coleta e análise de dados antropométricos: SISVAN – Sistema de Vigilância Alimentar e Nutricional. Brasília: Ministério da Saúde; 2011 [citado 2025 abr 7]. Disponível em: http://bvsms.saude.gov.br
Alexandre NMC, Coluci MZO. Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas. Cien Saude Colet 2011;16:3061–8. https://doi.org/10.1590/S1413-81232011000800006.
Brasil. Agência Nacional de Vigilância Sanitária. Resolução da Diretoria Colegiada - RDC nº 546, de 23 de dezembro de 2021. Dispõe sobre as boas práticas de fabricação de produtos de saúde. Brasília, 2021. Disponível em: https://antig.anvisa.gov.br/docu/10/63/RD.pdf/e3a-7df3-4ac-865b-e9a.
Thakkar PA, Yagnik K, Parmar NT, Das RR, Thakkar UP. Observer Variability in Head Circumference Measurement Using Routine Versus Non-Stretchable Tapes in Children. J Nepal Paediatr Soc 2018;37:238–43. https://doi.org/10.3126/jnps.v37i3.19556.
Devakumar D, Bamford A, Ferreira MU, Broad J, Rosch RE, Groce N, et al. Infectious causes of microcephaly: epidemiology, pathogenesis, diagnosis, and management. Lancet Infect Dis 2018;18:e1–13. https://doi.org/10.1016/S1473-3099(17)30398-5.
Conkle J, Ramakrishnan U, Flores-Ayala R, Suchdev PS, Martorell R. Improving the quality of child anthropometry: Manual anthropometry in the body imaging for nutritional assessment study (BINA). PLoS One 2017;12:1–13. https://doi.org/10.1371/journal.pone.0189332.
Wright CM, Bremner M, Lip S, Symonds JD. Does measurement technique explain the mismatch between European head size and WHO charts? Arch Dis Child 2017;102:639–43. https://doi.org/10.1136/archdischild-2016-311888.
Bartram JL. The “Lasso-o” tape: stretchability and observer variability in head circumference measurement. Arch Dis Child 2005;90:820–1. https://doi.org/10.1136/adc.2004.063743.
Sicotte M, Ledoux M, Zunzunegui M-V, Ag Aboubacrine S, Nguyen V-K. Reliability of anthropometric measures in a longitudinal cohort of patients initiating ART in West Africa. BMC Med Res Methodol 2010;10:102. https://doi.org/10.1186/1471-2288-10-102.
Pimenta JRR, Grandi C, Aragon DC, Cardoso VC. Comparison of birth weight, length, and head circumference between the BRISA-RP and Intergrowth‐21st cohorts. J Pediatr (Versão Em Port 2020;96:511–9. https://doi.org/10.1016/j.jpedp.2019.05.022.
