Stunted growth

Classification according to ICD-10
R62.8	Stunted growth
ICD-10 online (WHO version 2019)

A body length deviating from the norm in children and adolescents is designated as a growth disorder, whereby more than three standard deviations are considered to require clarification.

Synonyms are: incorrect growth; English Disturbance of growth

This includes all forms of short stature (hyposomy), tall stature and tall stature ( giant stature ) - terms that are not used uniformly synonymously.

In the case of generalized growth disorders, a distinction is made between short stature and tall stature. The short stature is usually the result of metabolic and / or endocrine disorders, while the tall stature is the result of an underlying endocrine disease.

Other possible causes can be found under malformation syndromes .

There are also intrauterine growth disorders .

An important research topic for biologists are also changes in the growth processes of plants under conditions of weightlessness in space. Numerous satellite experiments have been developed for this purpose, including a. for space stations of the USA and Russia.

Delay to thrive

definition

Delayed growth is not a disease in and of itself, but a description of the deviation from normal growth . When making a diagnosis , both the genetic target size of the child and the average size of the original population must be taken into account.

For this purpose, the so-called growth curves are used, which indicate the average height and weight of the children in this population by percentiles . Both the weight and the height of the child are entered in these at regular intervals. The course of growth is more important than the individual measurements.

The 50 percent percentile for weight indicates that 50% of children at a given age weigh less. The critical percentiles are the 97th and 3rd percentiles. Especially in the case of children with a migration background, the normal growth curves here must not be used to assess growth, but the curves of the country of origin must be used.

Another important parameter is the target length weight , which relates the current weight to the size. Because it may be that a child is not too light for its age, but simply has a normal weight and is too small.

In order to be able to diagnose a growth disorder, one of the following conditions must be met:

Target length weight below 60%
Weight below the 3rd percentile
Growth course crosses two main percentiles (90th, 75th, 50th, 25th, 10th and 5th percentiles)

causes

Classically, the growth disturbance was divided into organic and non-organic. However, it should be noted that it is usually a multifactorial event for which not a single cause can be found. An organic cause can only be found in about 5% of underweight children. Therefore, the excessive examination is usually not appropriate.

Inadequate caloric intake is the main cause of slowdown in the industrialized world. This is based on malnutrition or poor nutrition, on an increased energy expenditure or on a disturbance in the absorption of nutrients. In many chronic diseases, there is a secondary delay in growth due to the increased energy requirement and decreased appetite.

literature

W. Hoepffner, R. Pfäffle, R. Gausche, Chr. Meigen, E. Keller: Early Detection of Growth Disorders With the CrescNet System at the Leipzig Treatment Center. In: Deutsches Aerzteblatt Online. 2011, doi: 10.3238 / arztebl.2011.0123

Individual evidence

↑ Willibald Pschyrembel : Clinical Dictionary , 266th, updated edition, de Gruyter, Berlin 2014, ISBN 978-3-11-033997-0, keyword: "growth disorder"
^ FC Sitzmann: Pediatrics. Diagnostics - therapy - prophylaxis. 6th edition, Hippokrates 1988, p. 826, ISBN 3-7773-0827-7
↑ DLR research satellite grows tomatoes in space - WELT. Retrieved February 28, 2017 .
^ W. Nützenadel: Failure to thrive in childhood. In: Deutsches Ärzteblatt Int. 2011; 108 (38), pp. 642-649. doi: 10.3238 / arztebl.2011.0642
^ MD Shah: Failure to thrive in Children. In: Journal of Clinical Gastroenterology. 2002 Nov-Dec; 35 (5), pp. 371-374. PMID 12394222
↑ JC Wells: Growth and failure to thrive. In: Pediatric Nursing. 2002, 14 (3), pp. 37-42. PMID 12001354 .

[1] Willibald Pschyrembel : Clinical Dictionary , 266th, updated edition, de Gruyter, Berlin 2014, ISBN 978-3-11-033997-0, keyword: "growth disorder"

[2] FC Sitzmann: Pediatrics. Diagnostics - therapy - prophylaxis. 6th edition, Hippokrates 1988, p. 826, ISBN 3-7773-0827-7

[3] DLR research satellite grows tomatoes in space - WELT. Retrieved February 28, 2017 .

[4] W. Nützenadel: Failure to thrive in childhood. In: Deutsches Ärzteblatt Int. 2011; 108 (38), pp. 642-649. doi: 10.3238 / arztebl.2011.0642

[5] MD Shah: Failure to thrive in Children. In: Journal of Clinical Gastroenterology. 2002 Nov-Dec; 35 (5), pp. 371-374. PMID 12394222

[6] JC Wells: Growth and failure to thrive. In: Pediatric Nursing. 2002, 14 (3), pp. 37-42. PMID 12001354 .