Background: A programme of measuring birth length (BL) and parental heights (PH) for neonates classified as Small for Gestational Age (SGA, Birth Weight (BW) <9th centile, UK 1990 reference data) has been adopted in one Scottish hospital since 2008. Neonates with Short Stature (BL≤−2 standard deviation scores/SDS) are invited for re-measurement of weight and height at age 2 years, thus making medical services aware of individuals who have not had adequate catch-up growth relative to their family pattern.
Objective and hypotheses: To determine whether: (1) catch-up growth has occurred in neonates of short stature by age 2 years; (2) there is a genetic influence on their stature.
Method: BL and PH were measured for all SGA neonates born in Ayrshire Maternity Unit from October 2013-October 2014. Mid-parental height (MPH) and lower end of parental target range (LTR) were calculated (UK 1990 reference data). For those of short stature, height and weight at age 2 years was measured to determine catch-up growth.
Results: Of 3482 live births, BW was <9th centile in 416 neonates (11.9%). Short stature was detected in 89 neonates (21.4%) of 2842weeks gestational age (GA). To date, 34 children have been invited for follow-up, 24 (71%) of whom have attended. Of these, 3 (12.5%) remain ≤-2SDS for height comprising: a preterm infant (BW 1.15 kg, GA 304/7) with Ht SDS −3.26 at 2 years, maternal Ht SDS −2.34; and two term babies with Ht SDS −2.86 and −1.95 at 2 years (LTR SDS −2.05 and −2.12 respectively).
Conclusion: The smallest babies at birth were not the smallest at 2 years and those with the smallest parents had shown good catch-up growth. As expected ~10% of the short cohort remain short at 2 years, two of whom would not have been detected without the screening programme. The number of children requiring re-measurement at 2 years (89/3482) is relatively modest and consideration should be given to extending accurate BL measurement to infants with BW≤15th centile (462 in the current study) since it is known that a cut-off BW of ≤9th centile (n=257 for this study) will not detect all cases of short stature at birth1.
1Sardar et al., Short Stature Screening By Accurate Length Measurement Of Infants With Birthweight <9th Centile. Hormone Research in Paediatrics, 2015.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology