Short-Term Growth in Children with Congenital Adrenal Hyperplasia

Abstract

Objective: To describe short-term growth patterns in children with congenital adrenal hyperplasia (CAH). Methods: Height was measured daily in 5 children (1 boy) aged 3.9–9.7 years over 9–16 months. Kernel regression analysis was used to characterise short-term growth. The results were compared with data from 43 normal prepubertal children. Results: Growth was characterised by growth spurts with intervening periods of no discernible growth (stasis). Height gain was positively correlated with the mean amplitude of growth spurts (r = 0.9, p < 0.05). Patients with CAH spent significantly less time in stasis than normal children (5 ± 4.8 vs. 11.4 ± 7.2% of study period; p < 0.05), the mean length of growth spurts was significantly longer (110.4 ± 28.3 vs. 54.0 ± 13.1 days; p < 0.05) and the mean amplitude significantly lower (0.022 ± 0.008 vs. 0.037 ± 0.001 cm/day; p < 0.01). Conclusions: Compared with normal controls, short-term growth in children with CAH is characterised by long-duration low amplitude growth spurts with reduced periods of growth stasis. Better growth was correlated with the amplitude of growth spurts. The relatively smooth short-term growth in children with CAH suggests that if significant variations in growth rate are seen, they are more likely to be a consequence of under- or over-treatment rather than non-linear growth itself.