Short stature is a common problem in child health follow-up.
For normal growth, it is necessary to be healthy and happy, to eat right, and to have a normal hormone balance. If there is a problem with any of these, insufficient growth is seen.
Normal growth is the increase in height, body weight and head circumference within the expected values according to age, gender and genetic potential. Monitoring growth not only shows how much a child will grow, but also reveals how healthy he is. Accurate measurement, measuring by the same person in each examination, using the same device in the measurement will minimize the error. If the correct measurement is not made, the other measurements are of no value.
While children whose height is just under the 3% percentile have a structural or familial shortness rate of 80%, children with a height below 3 standard deviations have a higher rate of underlying systemic disease or endocrine disorder.
Short stature is defined as height below the third percentile (in other words, two standard deviations of the mean for age and sex) in growth curves prepared for age and sex.
Many diseases that present with different findings in adult life may manifest themselves only with short stature in childhood.
Growth includes intrauterine, infancy, childhood and adolescence. The average growth rate of 50 cm in the prenatal 9 months is 25 cm in the first year, 10-12 cm in the second year, and 8 cm in the third year. The elongation between the age of four and the onset of puberty averages 5-6 cm per year.
Evaluation of growth should include starting from the pregnancy period, birth history, postnatal nutrition, evaluation of height and weight measurements performed every 3 to 6 months, and questioning of previous diseases. Apart from this, family history, height measurements of parents, and height values of their parents and siblings should be questioned. Then a good physical examination, measurement of height, weight, body proportions (sitting, height, fathom length), puberty findings, dysmorphic findings should be carefully observed and recorded. Necessary diagnostic tests should be performed according to the examination findings.
Nutrition disorders and chronic diseases are the most important causes of postnatal short stature. The lack of nutrients such as protein and zinc and iron causes short stature. Psychosocial short stature can be seen in those who are in a negative family or home environment, and those with psychological disorders. Systemic diseases (such as poorly controlled diabetes, chronic kidney failure) may cause short stature. Low birth weight is one of the important factors affecting preterm birth growth potential.
While environmental factors and nutrition primarily affect growth in the first months of life, genetic factors come to the fore until the age of two after this period. Growth is under the influence of endocrine factors in the period between the age of three and puberty. If the curve is crossed downwards, endocrinological disorders that cause growth retardation such as hypothyroidism and growth hormone deficiency should be evaluated after systemic disease screening. It is detected by blood test and can be easily treated.
In adolescence, growth occurs with the effect of sex hormones as well as growth hormone.
Growth hormone directly affects growth. Growth hormone deficiency may develop congenital or due to brain damage during or after birth due to illness, radiation therapy or tumor. causes a short adult neck.
Height and body weight measurements repeated every three months in infants and every 6-12 months in children and adolescents give more detailed information about growth.
Children are not miniatures of adults. short stature or Children who are thought to have a growth arrest should be examined, followed up and examined by a Pediatric Endocrinologist.
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