Growth charts of Turkish children with Down syndrome

Abstract

We present growth curves of 1,726 Turkish children with Down syndrome (DS) between 0 and 18 years of age and investigate the factors that affect growth including congenital heart disease (CHD) and hypothyroidism. Longitudinal measurements of height, weight, and head circumference (HC) were assessed and accompanying major malformations were recorded. Growth curves were monitored using Cole's LMS method. The mean birth length was reduced by À0.5 standard deviation (SD) for Turkish standards in both boys and girls. Pubertal growth spurt of the girls with DS started 1 year earlier, their puberty duration was short and pubertal annual growth rate was inadequate, and as a result the final height was À3.06 SD for Turkish standards. Although the age at onset of pubertal growth spurt and puberty duration of the boys were similar to normal population, their pubertal annual growth rate was inadequate; thus the final height was À2.56 SD for Turkish standards. The final weight values were similar to normal population. The mean HC values of DS children were corresponded to À0.9 SD for Turkish standards at birth; however after 6 months values were below À2 SD. The final HC values were À1.02 SD for boys and À2.21 SD for girls for Turkish standards. We observed that weight was decreased in DS children with severe CHD during first 4 years of life. However, there is no statistically significant difference in values of height and head circumference between patients with or without severe CHD group. In addition, hypothyroidism had no effect on growth in DS patients. Ó 2012 Wiley Periodicals, Inc.Key words: Down syndrome; growth; charts; height; weight; head circumference INTRODUCTION Down syndrome (DS) is the most common chromosomal disorder and leading cause of intellectual disability and growth retardation. Average height is around the À2 standard deviation (SD) for most ages compared to normal population. The growth pattern is impaired from birth to adolescence and particularly during the interval of 6 months to 3 years and puberty [Cronk et al., 1988]. In addition, these patients also have reduced pubertal growth spurt, contributing to the low final height [Cronk et al., 1988;Anner en et al., 1990]. It was demonstrated that children with DS do not have growth hormone (GH) deficiency [Anner en et al., 1986], but hypothalamic dysfunction was reported by Castells et al. [1996]. A study performed by Anner en et al. [1999] revealed that GH was given to children with DS increased growth velocity. However, Myrelid et al. [2010] reported that GH treatment had no effect on final height.Since children with DS have different growth patterns than other normal children, it is critically important to utilize syndrome specific growth charts. First growth charts for DS have been developed by Roche [1965], followed by Rarick and Seefeldt [1974]. Cronk et al. [1988] was studied 780 children with DS between 1 month and 18 years of age and established growth charts with these data in USA and also showed that moderate to severe CHD affected growt...

Growth Patterns of Thai Children with Down Syndrome from Birth to 5 Years

“…17 Several research studies show that anomalies associated with DS, especially CHD usually affect physical growth patterns. 11,13,14 The number of DS children with CHD in our study is 47%, which is relatively similar to the existing literature of 40 to 50%, 7 53% of the samples in the United States 2015 study, 12 and 50% in the Chinese study. 20 Our growth patterns demonstrate both weight and length/height differences between the DS children with CHD and without CHD in both genders, and the differences are more noticeable in girls.…”

“…Turkish children with DS who have severe CHD have a significantly lighter weight than those without CHD from the age of 3 months to 4 years old. 13 Dutch DS children with severe CHD are significantly shorter and have a smaller head circumference than those without CHD. 14 Similarly, United States DS children with severe CHD, who are younger than 8 years old, are approximately 1.5 to 2 cm shorter in length/height and 0.5 to 2 kg lower in weight than the general children.…”

“…11,12 Since various disorders, including DS are known to interfere with child growth, the growth pattern characteristic for children with these conditions can vary significantly and differ from that of normal children. [10][11][12][13][14] Apart from specific disorders, national or ethnic groups and a proxy of multiple factors, such as genetic, food, environment, and socio-economic status could cause a difference in child growth. 15 Thus, country-specific growth charts for children with disorders are necessary to help clinicians in the country to conduct a proper growth assessment and monitoring.…”

“…Many countries have developed their own growth references and growth charts for children with DS. [10][11][12][13][14][16][17][18][19][20] However, no growth charts are available for the children with DS in Thailand. We have modeled our growth monitoring for Thai children with DS after the DS growth chart of the United States.…”

Somatic Growth of Brazilian Children and Adolescents With Down Syndrome

“…10 . However, a study of the Turkish population with SD 23 showed no statistically significant differences between the groups with or without severe heart disease and or hypothyroidism.…”