ASSESSMENT OF SHORT STATURE IN VERY-LOW-BIRTH-WEIGHT CHILDREN

The aims of this study of short very low birthweight (VLBW) children a t or after 8 years of age were to determine: (i) if there were any uns uspected organic causes for their growth failure; and (ii) whether any children might be suitable for treatment with synthetic growth hormon e. Thirty-seven of 195 (19%) VLBW children seen at 8 years had heights <10th centile, and of these only 40% (10/25) of families offered an a ssessment were concerned enough to have the child fully evaluated. No child had an unsuspected organic cause of short stature. The children' s parents were significantly shorter than expected for Caucasians (mea n parental height s.d. score = - 1.06 (s.d. 0.72), t = - 5.9, P<0.001) . On average, the bone age of the short children was delayed by 14.9 m onths (s.d. 18.8 months) compared with chronological age (t = -3.4, P< 0.01). When compared with their parents, the children's mean height s. d. score for their bone age was not significantly different (mean heig ht s.d. score for bone age = - 0.83 (s.d. 1.3), t = 0.6, NS). Only thr ee children qualified for treatment with synthetic growth hormone; all three had been small for gestational age at birth and had birthweight s <1000 g. In conclusion, in short VLBW children, only a minority of f amilies and children are likely to be concerned enough about short sta ture to be fully assessed; an unsuspected organic cause for growth fai lure is unlikely, and only a few will qualify for synthetic growth hor mone therapy.