Abstract
ObjectiveTo provide cross-sectional height and head circumference (HC) references for healthy Dutch children with Down syndrome (DS), while considering the influence of concomitant disorders on their growth, and to compare growth between children with DS and children from the general population.Study designLongitudinal growth and medical data were retrospectively collected from medical records in 25 of the 30 regional hospital-based outpatient clinics for children with DS in the Netherlands. Children with Trisomy 21 karyotype of Dutch descent born after 1982 were included. The LMS method was applied to fit growth references.ResultsWe enrolled 1,596 children, and collected 10,558 measurements for height and 1,778 for HC. Children with DS without concomitant disorders (otherwise healthy children) and those suffering only from mild congenital heart defects showed similar growth patterns. The established growth charts, based on all measurements of these two groups, demonstrate the three age periods when height differences between children with and without DS increase: during pregnancy, during the first three years of life, and during puberty. This growth pattern results in a mean final height of 163.4 cm in boys and 151.8 cm in girls (−2.9 standard deviation (SD) and −3.0 SD on general Dutch charts, respectively). Mean HC (0 to 15 months) was 2 SD less than in the general Dutch population. The charts are available at www.tno.nl/growth.ConclusionsHeight and HC references showed that growth retardation in otherwise healthy children with DS meanly occurs in three critical periods of growth, resulting in shorter final stature and smaller HC than the general Dutch population shows. With these references, health care professionals can optimize their preventive care: monitoring growth of individual children with DS optimal, so that growth retarding comorbidities can be identified early, and focusing on the critical age periods to establish ways to optimize growth.
Highlights
Appropriate, up-to-date growth charts are necessary for evaluation of physical growth and provision of optimal health care
Height and head circumference (HC) references showed that growth retardation in otherwise healthy children with Down syndrome (DS) meanly occurs in three critical periods of growth, resulting in shorter final stature and smaller HC than the general Dutch population shows
[2] Growth charts are available for various ethnic groups at specific moments in time. [3,4] Specific growth references have been developed for children with various disorders known to interfere with growth, such as Turner and Down syndrome (DS). [5,6,7,8,9] Since growth assessment depends on the growth pattern characteristic for these conditions, disorder specific charts are desirable
Summary
Appropriate, up-to-date growth charts are necessary for evaluation of physical growth and provision of optimal health care. The aim of the present study is to provide updated height and new HC growth references by a large nationwide sample, reflecting healthy growth in Dutch children with DS, and to compare their growth pattern with data from a recent nationwide study among children from the general Dutch population with focus on periods during which relative height differences increases. We think it is essential to establish new growth references for children with DS in the Netherlands, whereby a strict selection on their health status will be applied. With such references health care professionals can monitor growth of individual children with DS optimally, and can identify growth retarding comorbidities at an early stage
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