Height Growth Velocity Research Articles

The effect of day care attendance on infant and toddler’s growth

We aimed to study the association between day care attendance and changes in the height, weight and weight/height ratio over a 6-month period. Data were retrieved from three maternal and child health care centres. Parents were asked to fill a short questionnaire regarding the infant/toddler life style, the day care facilities and the family demographic information. One hundred and seventy infants participated in the study. The research group consisted of 85 infants that had placed in day care centre prior to the age of 18 months. The control group consisted of 85 infants who had placed in day care at a later age. The research group had significantly shorter stature 3 months after day care enrolment (mean height percentiles of 56.9 versus 66.3, respectively, p = 0.024,). This trend was more pronounced after 6 months (mean height percentiles of 52.3 versus 63.7, p = 0.022). We could not, however, demonstrate a concomitant significant deceleration in weight or weight/height percentiles. The explanation for this rather dramatic finding remains speculative. Possible mechanisms are stress-related growth hormone suppression. Our findings reinforce the importance of monitoring infant/toddler weight and height growth velocities, especially when he/she is introduced to day care.

Parental body size and early weight and height growth velocities in their offspring

BackgroundWhereas weight or height at a given age are the results of the cumulative growth experience, growth velocities allows the study of factors affecting growth at given ages. AimTo study the relationships between parental height and body mass index (BMI) and offspring's height and weight growth during infancy and childhood. Study designFrom the FLVSII population-based study, 235 parent–child trios belonging to 162 families examined in 1999. Outcome measuresFrom medical records and previous FLVS examinations, child's height and weight history were reconstructed. Weight and height growth velocities from birth to seven years were estimated from a modelling of individual growth curve and correlated with parent's body size in 1999. ResultsPonderal index and length at birth were significantly associated with maternal but not paternal BMI and height. In the first six months, height growth velocity was significantly associated with maternal stature (at three months: 0.12±0.05 and 0.02±0.05cm/month for a 10cm difference in maternal and paternal height respectively) and weight growth velocity with paternal BMI (at three months: 5.7±2.8 and 1.9±2.3g/month for a difference of 1kg/m2 in paternal and maternal BMI respectively). Between two and five years, height growth velocity was more significantly associated with paternal height whereas weight growth velocity was more closely associated with maternal BMI. ConclusionsEarly childhood growth is characterised by alternate periods associated specifically with maternal or paternal BMI and height. This novel finding should trigger the search for specific genetic, epigenetic or environmentally shared factors from the mothers and fathers.

LINE‐1 DNA methylation in Colombian school children is associated with birth weight and maternal BMI, and predicts physical growth

Early developmental exposures involve epigenetic modifications, such as DNA methylation, that influence subsequent health outcomes. We quantified CpG methylation (%5‐methylated cytosines, 5mC) of long interspersed nucleotide elements (LINE)‐1, an indicator of global DNA methylation, in blood DNA samples from 97 participants of an ongoing schoolchildren cohort in Bogota, Colombia, and examined its associations with sociodemographic factors and child growth. Mean age was 9.6 y; 49% were boys. Mean %5mC was 80.3% (range=71.0, 88.3). %5mC was 1.7% higher in boys than girls (P=0.01); it was inversely associated with birth weight (−0.1% per 100 g, P=0.01) and with current maternal BMI <18.5 kg/m2 (−2.2% vs. normal BMI, P=0.003). In longitudinal analyses over a median 2.5 y follow‐up, LINE‐1 methylation inversely predicted height and BMI growth velocities in boys (−0.1 cm/y, P=0.05; and −0.03 kg/m2/y, P=0.02, per 1 %5mC, respectively), but not in girls. These results highlight the importance of sex‐specific analyses when evaluating epigenetic effects. Future studies should consider analyses of gene‐specific methylation profiles to better understand the functional consequences of global hypomethylation on child health.

Weight and height growth velocities of Japanese boys and girls between age 7 and 14 years: a critical window for early adolescent overweight risk

Childhood overweight is an important worldwide problem of public health concern, with metabolic, physical and psychosocial complications. More and more evidence is accumulating that children who gain weight rapidly earlier in life are at higher risk of becoming overweight later in adulthood life. Therefore, in a seven-year longitudinal study, we studied mid-childhood and early adolescence weight and height growth velocities among 5,024 Japanese 2(nd) grade primary school boys and girls along with its effect on the likelihood of being overweight adolescents by the age of 14 y. Our findings showed that weight growth velocity of both sexes was associated with being overweight at the end of longitudinal study. Boys' risk of accelerated weight growth velocity and becoming overweight adolescents was almost doubled during ages 7 approximately 11 y and become reduced afterward. Otherwise, odds ratios of girls' weight growth velocity peaks were found only at ages from 9 approximately 10 and 10 approximately 11 y. Thus, we suggest a critical window of mid-childhood period associated with adolescence risk of overweight, and we recommend that studying weight growth determinants during 7 approximately 11 y of boys and 9 approximately 11 y of girls may help in developing and applying proper programs for prevention and intervention of overweight problem.

Impact of Medications Prescribed for Treatment of Attention-Deficit Hyperactivity Disorder on Physical Growth in Children and Adolescents With HIV

To examine the relationships between physical growth and medications prescribed for symptoms of attention-deficit hyperactivity disorder in children with HIV. Analysis of data from children with perinatally acquired HIV (N = 2251; age 3-19 years), with and without prescriptions for stimulant and nonstimulant medications used to treat attention-deficit hyperactivity disorder, in a long-term observational study. Height and weight measurements were transformed to z scores and compared across medication groups. Changes in z scores during a 2-year interval were compared using multiple linear regression models adjusting for selected covariates. Participants with (n = 215) and without (n = 2036) prescriptions were shorter than expected based on US age and gender norms (p < .001). Children without prescriptions weighed less at baseline than children in the general population (p < .001) but gained height and weight at a faster rate (p < .001). Children prescribed stimulants were similar to population norms in baseline weight; their height and weight growth velocities were comparable with the general population and children without prescriptions (for weight, p = .511 and .100, respectively). Children prescribed nonstimulants had the lowest baseline height but were similar to population norms in baseline weight. Their height and weight growth velocities were comparable with the general population but significantly slower than children without prescriptions (p = .01 and .02, respectively). The use of stimulants to treat symptoms of attention-deficit hyperactivity disorder does not significantly exacerbate the potential for growth delay in children with HIV and may afford opportunities for interventions that promote physical growth. Prospective studies are needed to confirm these findings.

Assessment of angle velocity in girls with adolescent idiopathic scoliosis

BackgroundAlthough it has been demonstrated that the peak height velocity (PHV) is a predictive factor of progression in adolescent idiopathic scoliosis (AIS), little is known about the usefulness of angle progression in clinical practice. The purpose of this study was to establish a relationship between height and angle velocities, as well as to determine if peak angle velocity (PAV) occurs at the same time than PHV.MethodsA retrospective study of a cohort of girls with idiopathic scoliotic curves greater than 10°. Data of 132 girls who participated in a previous retrospective study about growth in AIS were used to calculate height and angle velocities. Relationship between height and angle velocities was estimated by the use of a Linear Mixed Model.ResultsPHV and PAV take place simultaneously 1 year before menarche in progressive curves managed with a brace in AIS. Changes in angle velocity are influenced by changes in height growth velocity, in such a way that as from 6 months post-menarche, height growth velocity in this group of girls estimates curve progression velocity (β-coefficient -0.88, p = 0.04).ConclusionAs from 6 months post-menarche, there is an inverse relationship between height velocity and curve progression in the group of AIS girls with progressive curves managed with a brace. Because height velocity is decreasing from 1 year before menarche, this finding corroborates that at the end of puberty, there is still a risk of progression in this group of girls despite bracing. The assessment of both height and angle velocity might be useful in clinical practice at the time of assessing brace effectiveness and how long bracing has to be indicated.

Height growth velocity, islet autoimmunity and type 1 diabetes development: the Diabetes Autoimmunity Study in the Young.

Larger childhood body size and rapid growth have been associated with increased type 1 diabetes risk. We analysed height, weight, BMI and velocities of growth in height, weight and BMI, for association with development of islet autoimmunity (IA) and type 1 diabetes. Since 1993, the Diabetes Autoimmunity Study in the Young (DAISY) has followed children at increased type 1 diabetes risk, based on HLA-DR, -DQ genotype or family history, for the development of IA and type 1 diabetes. IA was defined as the presence of autoantibodies to insulin, GAD or protein tyrosine phosphatase islet antigen 2 twice in succession, or autoantibody-positive on one visit and diabetic at the next consecutive visit within 1 year. Type 1 diabetes was diagnosed by a physician. Height and weight were collected starting at age 2 years. Of 1,714 DAISY children <11.5 years of age, 143 developed IA and 21 progressed to type 1 diabetes. We conducted Cox proportional hazards analysis to explore growth velocities and size measures for association with IA and type 1 diabetes development. Greater height growth velocity was associated with IA development (HR 1.63, 95% CI 1.31-2.05) and type 1 diabetes development (HR 3.34, 95% CI 1.73-6.42) for a 1 SD difference in velocity. Our study suggests that greater height growth velocity may be involved in the progression from genetic susceptibility to autoimmunity and then to type 1 diabetes in pre-pubertal children.

Symphysiofundal height growth curve and growth velocity in pregnant women in a Nigerian community

SummaryA prospective survey of symphysiofundal height (SFH) was undertaken in 202 Nigerian pregnant women in Uromi, Edo State, Nigeria, with the objective of constructing an SFH growth chart for the pregnant population in the community. A customised gravidogram and a growth velocity curve were also constructed and compared with those derived in other regions of the world. The average SFH growth rate between 20 and 40 weeks was 0.8 cm/week. The gradient of the curve was not constant and the SFH growth rate changed with the progression of pregnancy. While the average SFH growth rate between 20 and 36 weeks was 0.9 cm/week, from 36 to 40 weeks there was a marked deceleration to 0.3 cm/week. The average deviation from the mean SFH was 1.96 cm. It is recommended that regional customised gravidograms be derived for different pregnant populations which should be reviewed periodically. With this, routine SFH assessments can help in early detection of fetal growth rate anomalies based on an understanding of the peculiarities of fetal growth patterns in each community.

Impaired Postnatal Growth of Infants Prenatally Exposed to Cigarette Smoking

Most of the previous studies have shown a significant inverse relationship between smoking during pregnancy and weight, height and head circumference of infants at birth, but there is limited literature that assesses the head circumference measures of infants of smoker mothers in postnatal follow-up. The aim of this study was to assess the effects of maternal smoking and passive smoking during pregnancy on postnatal anthropometric measures of infants. Infants were divided into 3 groups: infants of smokers (n = 48), passive smokers (n = 57) and nonsmokers (n = 54), and were evaluated for their weight, height and head circumference at birth, 3 months and 6 months of age. Infants of smokers showed significant weight and head circumference deficits at birth compared to nonsmokers' infants (p < 0.05 and p < 0.001, respectively). At 6 months of age, infants of smokers continued to show significant deficits in all 3 measures compared to nonsmokers' infants (p < 0.001 for each), and infants of passive smokers showed only marginal decreases. Moreover, the weight and height growth velocities of the smokers' infants remained deficient, whereas their growth velocity of the head circumferences increased from birth up to 6 months and reached the growth velocity of the nonsmokers' infants. Infants of passive smokers showed a complete catch-up growth at 6 months. This study indicates that smoking during pregnancy results in serious deficits in infants' growth even after birth. Therefore, it is essential to inform smoker women before pregnancy the possible growth retardation of infants.

Early Markers of Pubertal Onset: Height and Foot Size

This longitudinal study compared the timing of foot and height velocities with pubertal onset in girls. There was no difference between ages of increased foot and height growth velocities; both occurred before onset of secondary sexual characteristics. Change in foot size may represent an early marker for transition to puberty.

Nasal Growth and Maturation Age in Adolescents

To define the end of the nasofacial growth spurt in order to schedule rhinoseptoplasty in patients with cleft without disturbing nasofacial growth. We searched the PubMed and Cochrane bibliographic databases from inception through December 31, 2007, using the primary indexing term facial growth with the confining search terms growth AND (face OR nose) AND (cephalometry OR anthropometry). The reference lists of the retrieved articles were searched for missed relevant studies. Articles written in English, German, or Dutch were included in the review. Studies of white adolescents without genetic disorders or malformations whose growth patterns had been followed up from at least 12 years of age until 18 years of age, with intervals between relevant measurements not longer than 2 years, were selected for this review. A reviewer performed data extraction by obtaining raw study data from the selected studies or by requesting them from the authors. Growth velocity curves were fit to different relevant measures for nasofacial growth. The end of the nasofacial growth spurt was defined as the age at which these growth velocity curves have their steepest descending slope. This definition yielded an average age of 13.1 years for adolescent girls and 14.7 years for adolescent boys. Because no information could be found for the spread in age of nasal growth spurt of individuals, 2 SDs of the age distribution for body height growth velocity were added. This resulted in 98% of white adolescent girls being nasally mature at the age of 15.8 years and 98% of white adolescent boys being nasally mature at the age of 16.9 years. Rhinoseptoplasty can safely be performed after the age of 16 years in girls and 17 years in boys.

Inducing puberty

Puberty is the result of increasing pulsatile secretion of the hypothalamic gonadotropin releasing hormone (GnRH), which stimulates the release of gonadotropins and in turn gonadal activity. In general in females, development of secondary sex characteristics due to the activity of the gonadal axis, i.e., the growth of breasts, is the result of exposure to estrogens, while in boys testicular growth is dependent on gonadotropins and virilization on androgens. Hypogonadotropic hypogonadism is a rare disease. More common is the clinical picture of delayed puberty, often associated with a delay of growth and more often familial occurring. Especially, boys are referred because of the delay of growth and puberty. A short course (3-6 months) of androgens may help these boys to overcome the psychosocial repercussions, and during this period an increase in the velocity of height growth and some virilization will occur. Hypogonadotropic hypogonadism may present in a congenital form caused by developmental disorders, some of which are related to a genetic disorder, or secondary to hypothalamic-pituitary dysfunction due to, among others, a cerebral tumor. In hypogonadotropic hypogonadism puberty can be initiated by the use of pulsatile GnRH, gonadotropins, and sex steroids. Sex steroids will induce development of the secondary sex characteristics alone, while combined administration of gonadotropins and GnRH may induce gonadal development including fertility.

Valoración antropométrica de la composición corporal de Bailarines de ballet. Un estudio longitudinal

The body of the adolescent dancer is the result of morphological, physiological and behavioral adaptations due to specific physical training. For the ballet master, body weight is irrelevant to evaluating the technical and artistic performance and beauty of a figure. All ballet dancers must have bodies that conform to the canon of international ballet in order to be able to perform in public. The purpose of this study is to describe the changes in the body composition of dancers at the Cuban National School of Ballet between two points in their training process. This was a longitudinal study of 54 girls and 40 boys, aged between 15 and 20 years old. An anthropometric protocol of 6 measurements was employed in order to determine body composition using the Durnin and Rahaman method for females and the Parizková and Buzková method for males. The main results demonstrate signifi cant increases in both weight and height for age in both sexes, and it was observed that height growth velocity decreased with age. The female dancers exhibited stable body fat percentages for all ages while male dancers signifi cantly reduced this percentage from one year to the next. The female students exhibited higher mean percentage body fat values than the normal range established in Cuba for elite athletes from competitive artistic sports and professional dancers, while the male students exhibited body fat percentages that were similar to these specialized groups.

Estudo longitudinal do crescimento corporal de escolares de 10 a 14 anos: dimorfismo sexual e pico de velocidade

Monitoring physical growth during adolescence provides an important indicator of health status and also makes it possible to identify individuals’ maturity stages. The objectives of this study were to: a) describe the progression of the heights and the body mass of girls and boys from 10 to 14 years of age and the differences between the sexes, and; b) to identify the point and magnitude of peak height growth velocity (PHV) and peak body mass velocity (PMV) for boys and girls. In order to achieve these objectives 70 schoolchildren of both sexes were followed from 10 to 14 years of age. Their height (cm) and body mass (kg) were measured annually from 2001 to 2005. The results demonstrate that up until 12 years of age there are no consistent differences between the sexes, but that at 13 and 14 years of age the boys are taller and heavier than the girls. The PHV and PMV both occurred during the same periods, being from 12 to 13 for boys and from 10 to 11 for the girls. Based on these results we concluded that until the boys reach their PHV, there is no significant difference in physical growth between the sexes and that after this point the boys become taller and heavier than the girls. Furthermore, we concluded that girls reach PHV and PMV around 2 years before the boys.

Postnatal weight and height growth velocities at different ages between birth and 5 y and body composition in adolescent boys and girls

BackgroundRapid weight gain in the first years of life is associated with adult obesity. Whether there are critical windows for this long-term effect is unclear. ObjectiveThe objective was to study anthropometric measures in adolescence by sex according to weight and height growth velocities at different ages between birth and 5 y. DesignAnthropometric measures, including fat and fat-free mass by bipodal impedancemetry, were measured in 468 adolescents aged 8–17 y. We retrospectively collected early infancy data and individually estimated weight and height growth velocities in 69.4% of them using a mathematical model. Associations between birth variables, growth velocities, and anthropometric measures in adolescence were studied. ResultsWeight growth velocity at 3 mo was associated with overweight (odds ratio for a 1-SD increase: 1.52; 95% CI: 1.04, 2.22), fat mass, and waist circumference in adolescence in both sexes and with fat-free mass in boys (r = 0.29, P < 0.001) but not in girls (r = −0.01, NS). Weight growth velocities after 2 y were associated with all anthropometric measures in adolescence, in both sexes. Between 6 mo and 2 y, weight growth velocities were significantly associated only with adolescent height in boys; in girls, associations with fat mass in adolescence were weaker. ConclusionOur results support the hypothesis of 2 critical windows in early childhood associated with the later risk of obesity: up to 6 mo and from 2 y onward. The study of the determinants of growth during these 2 periods is of major importance for the prevention of obesity in adolescence.

4: Early Markers of Pubertal Onset: Height and Foot Size

Defining the onset of puberty is critical in predicting physical and emotional changes that ultimately affect adult health behaviors. Physical examination using Tanner criteria by a trained professional is the gold standard for assessing pubertal onset. However, physical exams cannot always be conducted. Recording a less invasive measure may be more practical. The purpose of this study was to compare age of maximum foot and height growth velocities with the age of onset of puberty, defined as age at visualization of secondary sexual characteristics.

Impacto del diagnóstico de la enfermedad celíaca en el control metabólico de la diabetes tipo 1

To asses the prevalence of celiac disease and to evaluate the clinical effects of a gluten-free diet on metabolic control and growth in children and adolescents with type 1 diabetes mellitus (DM1).We performed a retrospective study of 261 patients with DM1. Diagnosis of celiac disease was based on the presence of endomysium and tissue transglutaminase antibodies in serum and was confirmed by intestinal biopsy. The impact of a gluten-free diet on metabolic control (mean annual HbAlc values), growth (height and annual growth velocity) and nutritional status (body mass index) was evaluated. Patients diagnosed with DM1 and subsequently with celiac disease were compared with a control group of patients with DM1 only.Twenty-one (8%) of the 261 diabetic patients were diagnosed with celiac disease and 19% also had another associated autoimmune disease. No significant differences were found in growth or metabolic control after withdrawal of gluten from the diet.We found a high prevalence of celiac disease in our type 1 diabetes population. A gluten-free diet had no effects on metabolic control of diabetes or on height or weight. Nevertheless, given the high prevalence of celiac disease and the possible development of long-term complications, such as lymphoma and osteoporosis, we recommend systematic screening in all diabetic patients, especially in the first 5 years after diagnosis of DM1.

Skeletal Age Assessment from the Olecranon for Idiopathic Scoliosis at Risser Grade 0

The main progression of idiopathic scoliosis occurs during peak height growth velocity, which is between the ages of eleven and thirteen years in girls and thirteen and fifteen years in boys and corresponds to the accelerating phase of pubertal growth. The Risser sign remains at grade 0 during this stage of growth. Triradiate cartilage closure occurs at approximately twelve years of age in girls and fourteen years in boys, which is in the middle of this phase. In addition to regular height measurements, a more detailed evaluation of skeletal maturity would be desirable prior to the identification of Risser grade 1. From the method of Sauvegrain et al., Diméglio derived a simplified method based on the radiographic appearance of the olecranon, which allows skeletal age to be assessed in six-month intervals. The purpose of this study was to determine the accuracy and the value of this simple method for the follow-up of patients with scoliosis. Five radiographic images demonstrate the typical characteristics of the olecranon during pubertal growth: two ossification nuclei, a half-moon image, a rectangular shape, the beginning of fusion, and complete fusion. This classification method was evaluated by three experienced and independent observers from lateral radiographs of the elbow in 100 boys and 100 girls with idiopathic scoliosis during the time of peak height velocity. Skeletal ages were correlated with the integral Sauvegrain method. The degree of interobserver concordance was determined, and skeletal age was compared with chronological age and the time of triradiate cartilage closure. For the three observers, the average concordance between the Sauvegrain and olecranon methods was excellent (r = 0.977 for boys and r = 0.938 for girls). The interobserver agreement was also excellent (r = 0.987 for the olecranon method and r = 0.958 for the Sauvegrain method for boys, and r = 0.992 and r = 0.985, respectively, for girls). Skeletal and chronological age were considered to correspond to each other within a six-month range for 49% of the boys and 51% of the girls, while 25% of the boys and 26% of the girls had an advanced skeletal age and 26% of boys and 23% of girls had a delayed skeletal age. Triradiate cartilage closure occurred at the same time as the appearance of the rectangular shape of the olecranon in 65% of the boys and 61% of the girls, corresponding to skeletal ages of fourteen and twelve years, respectively. In 91% of the boys and 88% of the girls, the triradiate cartilage fused within six months before to six months after the appearance of the rectangular shape of the olecranon, which occurred between the half-moon image and the beginning of fusion of the olecranon. The method of assessing skeletal age from the olecranon allows skeletal maturity to be evaluated in regular six-month intervals during the phase of peak height velocity. This method is simple, precise, and reliable. It complements the Risser grade-0 and the triradiate cartilage evaluation.

Sex‐specific Responses to Zinc Supplementation in Nouna, Burkina Faso

To study the different responses by sex to zinc supplementation among young children. STUDY CHILDREN AND METHODS: Double-blind randomized controlled trial of zinc supplementation in 686 children aged 6-30 months, conducted in Nouna, a rural area of Burkina Faso. Children received either a 12.5-mg zinc sulfate tablet or a placebo every day for about 6 months. Outcomes were morbidity, nutritional status, and mortality. Results revealed significant differences between boys and girls in their responses to zinc supplementation. Boys who received the zinc preparation had fewer days with diarrhea than did control boys (RR = 0.88, P = 0.05), especially less nonfebrile diarrhea (RR = 0.72, P < 0.001) and less dysentery (RR = 0.65, P = 0.05), but more ear infections (RR = 4.00, P < 0.001). By contrast, girls who received the zinc supplement had the same prevalence of diarrhea as did control girls, but more dysentery (RR = 3.70, P < 0.001), fewer ear infections (RR = 0.39, P < 0.001), and fewer eye infections (RR = 0.41, P < 0.001). The effect of supplementation on nutritional status was not detectable in boys, but girls who received supplementation experienced a faster growth velocity in height than did control girls (P = 0.004) and a faster growth velocity for weight and height if they were wasted and not stunted at baseline (P = 0.003). Zinc supplementation had positive, nil, or negative effects depending on pathological condition, and the effects were different for boys than for girls.

Growth in treated classical galactosemia patients

Decreased height and weight in treated children with classical galactosemia have been reported. However, growth has not been extensively studied. Patients might be at risk for an abnormal growth because of either disease-related intrinsic factors or diet-related factors. The objective was to gain insight in growth in treated children and adolescents with classical galactosemia. The studied population was a previously reported group of 40 classical galactosemia children. Prenatal growth was evaluated using length, weight and head circumference (HC) data from welfare centers or parents. Postnatal growth was evaluated using three height and weight measurements at baseline, 1 and 2 years to calculate growth velocities. Height Z-score was also corrected for target height Z-score (height Z-score divided by target height Z-score). Linear regression analysis was performed between growth velocities, IGF-I, IGFBP-3, dietary intake and galactose-1-phosphate-uridyltransferase activity. We found normal length (median 50.5 cm), weight (median 3,255 grams) and HC (median 33.9 cm) at birth. Mean height growth velocity was 0.87+/-1.2 for boys and -0.89+/-2.1 for girls, and mean weight growth velocity was 0.91+/-1.6 for boys and -0.74+/-1.3 for girls. Mean height corrected for target height was -1.5+/-0.9 in girls and -0.6+/-0.7 in boys. Height growth velocity was correlated with IGF-I (Pearson correlation= 0.499), IGFBP-3 (Pearson correlation 0.4) and height Z-scores corrected for target height Z-scores (Pearson correlation=0.550). Five children grew beyond the age of 18 years. In conclusion, prenatal growth was normal but postnatal growth was affected. Predicted final height is less than target height in most patients; however, target height might be reached for the children who grow beyond the age of 18. Decreased IGF-I and IGFBP-3 and or suboptimal hormonal replacement in girls might play a role.