scholarly journals Growth failure: “idiopathic” only after a detailed diagnostic evaluation

2021 ◽  
Author(s):  
Robert Rapaport ◽  
Jan M Wit ◽  
Martin O Savage
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Short Stature ◽  
Growth Failure ◽  
Diagnostic Techniques ◽  
Gh Treatment ◽  
Genetic Sequencing ◽  
Short Children ◽  
The Us ◽  
Catch Up

The terms idiopathic short stature (ISS) and small for gestational age (SGA) were first used in the 1970s and 1980s. ISS described non-syndromic short children with undefined aetiology who did not have growth hormone (GH) deficiency, chromosomal defects, chronic illness, dysmorphic features or low birth weight. Despite originating in the pre-molecular era, ISS is still used as a diagnostic label today. The term SGA was adopted by paediatric endocrinologists to describe children born with low birth weight and/or length, some of whom may experience lack of catch-up growth and present with short stature. GH treatment was approved by the FDA for short children born SGA in 2001, and by the EMA in 2003, and for the treatment of ISS in the US, but not Europe, in 2003. These approvals strengthened the terms SGA and ISS as clinical entities. While clinical and hormonal diagnostic techniques remain important, it is the emergence of genetic investigations that have led to numerous molecular discoveries in both ISS and SGA subjects. The primary message of this article is that the labels ISS and SGA are not definitive diagnoses. We propose that the three disciplines of clinical evaluation, hormonal investigation and genetic sequencing should have equal status in the hierarchy of short stature assessments and should complement each other to identify the true pathogenesis in poorly growing patients.

scholarly journals Growth Hormone Treatment in Short Children Born Prematurely—Data from KIGS

2011 ◽  
Vol 96 (6) ◽  
pp. 1687-1694 ◽  
Author(s):  
Margaret C. S. Boguszewski ◽  
Hanna Karlsson ◽  
Hartmut A. Wollmann ◽  
Patrick Wilton ◽  
Jovanna Dahlgren
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Growth Response ◽  
Growth Failure ◽  
Hormone Treatment ◽  
Height Velocity ◽  
First Year ◽  
Gh Treatment ◽  
Provocative Test ◽  
Short Children

Context: Children born prematurely with growth failure might benefit from GH treatment. Objectives: The aim was to evaluate the first year growth response to GH treatment in short children born prematurely and to identify predictors of the growth response. Design/Patients: A total of 3215 prepubertal children born prematurely who were on GH treatment were selected from KIGS (The Pfizer International Growth Database), a large observational database. They were classified according to gestational age as preterm (PT; 33 to no more than 37 wk) and very preterm (VPT; <33 wk), and according to birth weight as appropriate for gestational age [AGA; between −2 and +2 sd score (SDS)] and small for gestational age (SGA; −2 SDS or below). Results: Four groups were identified: PT AGA (n = 1928), VPT AGA (n = 629), PT SGA (n = 519), and VPT SGA (n = 139). GH treatment was started at a median age of 7.5, 7.2, 6.7, and 6.0 yr, respectively. After the first year of GH treatment, all four groups presented a significant increase in weight gain and height velocity, with a median increase in height SDS higher than 0.6. Using multiple stepwise regression analysis, 27% of the variation in height velocity could be explained by the GH dose, GH peak during provocative test, weight and age at GH start, adjusted parental height, and birth weight SDS. The first year growth response of the children born PT and SGA could be estimated by the SGA model published previously. Conclusion: Short children born prematurely respond well to the first year of GH treatment. Long-term follow-up is needed.

scholarly journals Prevalence of children born small for gestational age with short stature who qualify for growth hormone treatment

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Gianluca Tamaro ◽  
Mariagrazia Pizzul ◽  
Giuliana Gaeta ◽  
Raffaella Servello ◽  
Marina Trevisan ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Short Stature ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Well Being ◽  
Italian Population ◽  
Gh Treatment ◽  
Short Children ◽  
Catch Up ◽  
Rhgh Treatment

Abstract Background Recombinant human growth hormone (rhGH) is approved in Europe as a treatment for short children born small for gestational age (SGA) since 2003. However, no study evaluated the prevalence of SGA children with short stature who qualify for rhGH in Europe so far. This study aimed to investigate in an Italian population the prevalence of children born SGA, of short stature in children born SGA, and of SGA children who qualify for rhGH treatment at 4 years of age. Methods We conducted a population-based study on primary care pediatricians’ databases in Trieste, Italy. Data was collected on 3769 children born between 2004 and 2014. SGA was defined as birth weight and/or birth length ≤ − 2 SDS. Data on height and weight were registered at the closest well-being visit to 1, 2, 3, 4 years of age. Short stature was defined as height ≤ − 2 SDS. Short children born SGA who qualify for rhGH treatment were identified according to Note AIFA #39 criteria (age ≥ 4 years; height ≤ − 2.5 SDS; growth velocity < 50th percentile). Results Full data at birth were available for 3250 children. The SGA prevalence was 3.6% (0.8% SGA for weight, 2.2% SGA for length, 0.6% SGA for both weight and length). The prevalence of short stature among SGA children was 9% at 1 year of age, 6% at 2 years (significantly higher in preterm in the first 2 years), 4% at 3 years, 3% at 4 years (all born at term). At 4 years of age, median height SDS was − 0.52. One child born SGA was eligible for GH treatment (0.8% among SGA children). Conclusions The prevalence in a general pediatric population of children born SGA who qualify for GH treatment was 1:3250. Although the prevalence of SGA in our population was similar to previous studies, catch-up growth was recorded earlier in our sample compared to previous reports, and term babies had late catch-up. Height SDS of children born SGA at 4 years of age was lower than expected (− 0.52 SDS).

Primary Follow-up Care in a Multidisciplinary Setting Enhances Catch-up Growth of Very-low-birth-weight Infants

1997 ◽  
Vol 97 (4) ◽  
pp. 386-390 ◽  
Author(s):  
STEPHANIE R. BRYSON ◽  
LEA THERIOT ◽  
NELL J. RYAN ◽  
JANET POPE ◽  
NANCY TOLMAN ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Follow Up Care ◽  
Catch Up

scholarly journals Stunting at birth and associated factors among newborns delivered at the University of Gondar Comprehensive Specialized Referral Hospital

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245528
Author(s):  
Almaz Tefera Gonete ◽  
Bogale Kassahun ◽  
Eskedar Getie Mekonnen ◽  
Wubet Worku Takele
Keyword(s):  
Logistic Regression ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Short Stature ◽  
Odds Ratio ◽  
Associated Factors ◽  
Adjusted Odds Ratio ◽  
Referral Hospital ◽  
Factors Associated ◽  
The University

Background Stunting at birth is a chronic form of undernutrition majorly attributable to poor prenatal nutrition, which could persist in children’s later life and impact their physical and cognitive health. Although multiple studies have been conducted in Ethiopia to show the magnitude of stunting and factors, all are concentrated on children aged between 6 to 59 months. Therefore, this study was done to determine the prevalence and associated factors of stunting at birth among newborns delivered at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest, Ethiopia. Methods An institution-based cross-sectional study was conducted from February 26th to April 25th/2020. A systematic random sampling technique was used, to select a total of 422 newborn-mother pairs. The binary logistic regression was employed to identify factors associated with stunting and all independent variables were entered into the multivariable logistic regression model to adjust for confounders. Variables that had significant association were identified based on p-value < 0.05 and the adjusted odds ratio with its respective 95% confidence interval was applied to determine the strength as well as the direction of the association. Results About 30.5% (95% CI: 26.3%, 35.1%) of newborns were stunted at birth. Being male [Adjusted odds ratio (AOR) = 2.9(1.62, 5.21)], newborns conceived in Kiremt(rainy season) [AOR = 2.7(1.49, 4.97)], being low birth weight [AOR = 3.1(1.64, 6.06)] were factors associated with stunting at birth. Likewise, newborns born to short stature mothers [AOR = 2.8(1.21, 6.62)] and chronically malnourished mothers [AOR = 15.3(8.12, 29.1)] were at greater risk of being stunted. Conclusion Just under a third of newborns are stunted at birth, implying a pressing public health problem. Newborns born to chronically malnourished and short stature mothers were more stunted. Besides, stunting was prevalently observed among male neonates, newborns conceived in Kiremet, and being low birth weight. Thus, policymakers and nutrition programmers should work on preventing maternal undernutrition through nutrition education to reduce the burden of low birth weight and stunting. Further, paying due attention to newborns conceived in Kiremet season to improve nutritional status is recommended.

scholarly journals Prediction of Postnatal Growth Failure among Very Low Birth Weight Infants

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Soon Min Lee ◽  
Namhyo Kim ◽  
Ran Namgung ◽  
Minsoo Park ◽  
Kookin Park ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Growth Failure ◽  
Postnatal Growth ◽  
Low Birth Weight Infants ◽  
Postnatal Growth Failure

scholarly journals Catch-up growth and associated factors in very low birth weight infants

2020 ◽  
Vol 93 (5) ◽  
pp. 282-288
Author(s):  
Teodoro Durá-Travé ◽  
Isabel San Martín-García ◽  
Fidel Gallinas-Victoriano ◽  
María Jesús Chueca-Guindulain ◽  
Sara Berrade-Zubiri
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Associated Factors ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Catch Up

scholarly journals Predictors of mortality among HIV exposed infants at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
Chalachew Adugna Wubneh ◽  
Aklilu Endalamaw ◽  
Nigusie Birhan Tebeje
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Hiv Infection ◽  
Exclusive Breastfeeding ◽  
Cox Regression ◽  
Growth Failure ◽  
Predictors Of Mortality ◽  
Hiv Exposed Infants ◽  
Hiv Exposed

Abstract Background In the era of highly active antiretroviral therapy, vertical HIV transmission has been decreased. This may increase fertility desire of HIV infected women and an increasing number of HIV exposed infants as a result. A high probability of mortality among HIV exposed infants was reported across different countries. However, few studies are found on mortality of HIV exposed infants, in particular, no study was conducted before in the current study area. Methods Institution based retrospective cohort study from July 2013 to December 2017 was conducted. A total of 408 HIV exposed children were selected through simple random sampling technique. Data were extracted from registration book by using data extraction tool, which is adapted from the Ethiopian Federal Ministry of Health HIV exposed infant follow-up form. Kaplan–Meier survival curve was used to show the probability of mortality rate. Bivariable and multivariable cox regression models were used to identify predictors of mortality. Results Overall mortality rate was found to be 8.88 (95% CI: 6.36–12.36) per 100 child-year. Infant with death of at least one parent (AHR = 3.32; 95% CI: 1.503–7.32), non-exclusive breastfeeding (AHR = 0.10; 95% CI: 0.037–0.302), growth failure (AHR = 2.9; 95% CI: 1.09–8.09), presence of sign and symptom of HIV infection (AHR = 2.99; 95% CI: 1.33–6.74), and low birth weight (AHR = 2.6; 95% CI: 1.007–6.78) were found to be predictors of infant mortality. Conclusions Mortality of HIV exposed infants was high in Ethiopia. Prevention of the occurrence of HIV infection symptom, growth failure, and low birth weight is essential and further treat early whenever they occurred. Still, behavioral change interventions on mother who practice non-exclusive breastfeeding are indicated. Especial care for orphan infants is required due to their nature of vulnerability to varieties of health problem.

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