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Growth patterns of children with short stature in adulthood according to auxological status and maturity at birth.

R. Pfäffle,M. Knüpfer,Melanie Göbert,M. Vogel,R. Gausche,Christoph Beger,E. Keller,A. Körner,U. Thome,W. Kiess

Published 2022 in Journal of Clinical Endocrinology and Metabolism

ABSTRACT

In this study we aimed to recognize differences in growth patterns of children according to sex, maturity and auxological status at birth facilitating earlier identification of SGA children with adult short stature. Growth data of 44791 infants born between January 1, 1980, and December 30, 2012, within two pediatric cohorts with follow up through December 31, 2020, were analyzed. 5698 children next to birth-data had measurements at near final height (nfh) and at least two further points. Preterm children (gestational age <37 weeks) had a significantly lower mean nfh SDS than term children (preterm, -0.61; term, -0.18), and a higher likelihood of nfh <3rd percentile (preterm, 20.5%; term, 12.2%). SGA born children also had a lower mean nfh SDS than children born appropriate for gestational age (AGA) (SGA, -1.06; AGA, -0.15) and a higher likelihood of nfh <3rd percentile (SGA, 28.2%; AGA 10.1%). Of 1204 SGA children 672 (56%) showed successful catch-up growth to nfh ≥10th percentile (SGA-CU), 532 children (44%) did not (SGA-S). The difference in their mean nfh SDS (SGA-CU, -0.12; SGA-S -2.26) can only partly be explained by the differences in mean mid-parental height SDS (SGA-CU, -0.3; SGA-S, -1.19). During the 1st year SGA-CU showed higher catch-up growth (SGA-CU, +1.2 SDS; SGA-S, +0.45 SDS), which helps to earlier discriminate between groups. Final growth outcome was influenced by prematurity and auxological status at birth, but not by sex. Height/length SDS increments during year 1 are instrumental to discern SGA children with later normal or short stature. Whereas observing catch-up growth until year 2 and 3 can add specificity, discrimination thereafter becomes difficult.

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