Familial Short Stature and SGA ✅ Flashcards
What is the most common cause of short stature referred to clinical services?
Familial short stature
What is required to demonstrate familial short stature?
Calculating the target height range
What should be considered if one parent is particularly short?
If they too have a potentially inheritable underlying growth disorder
What will children with familial short stature show in their growth chart?
Height centile consistent with their short target height range, and growth parallel to the centiles and consistent with a normal height velocity
How is familial short stature managed?
Careful explanation and reassurance for the child and parents
Extensive investigation not indicated
When is short stature due to being small for gestational age suggested?
When the birth weight is below the 10th centile
What does symmetrical growth failure in utero suggest?
Adverse influences on fetal growth that have operated throughout much of development
What is meant by asymmetrical growth?
When head circumference is preserved
What does asymmetrical growth failure in utero suggest?
Growth failure restricted to the last part of pregnancy, often placental failure
What % of SGA infants will show catch-up growth postnatally?
80-85%
Are infants with symmetrical or asymmetrical intrauterine growth resection more likely to show catch-up growth postnatally?
Asymmetrical
What are SGA infants at higher risk of in the first 2 days of life?
Hypoglycaemia
What are SGA infants at higher risk of longer term?
A range of adult diseases, including hypertension, cardiovascular disease, T2DM, and obesity
What has been proposed to explain why SGA foetuses are at higher risk of certain adult diseases?
The Barker hypothesis
What is the Barker hypothesis?
That there are critical periods in fetal development where permanent adaptive changes occur in body structure and function to cope with nutritional insufficiency in utero and likely nutritional challenges postnatally. However, these adaptations place the individual at a disadvantage postnatally should calorie supplies become potentially unlimited.
