PEDIATRICS Vol. 95 No. 6 June 1995, pp. 917-923
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Slow Prepubertal Linear Growth but Early Pubertal Growth Spurt in Patients With Shunted Hydrocephalus

Tuija Löppönen MD1, Anna-Liisa Saukkonen MD1, Willy Serlo MD1, Peter Lanning MD2, and Mikael Knip MD1

1 Department of Pediatrics, University of Oulu, Oulu, Finland
2 Department of Diagnostic Radiology, University of Oulu, Oulu, Finland

Objective. To evaluate growth and to compare anthropometric measures and the degree of physical maturation in children with shunted hydrocephalus with those in healthy children.

Methods. One hundred fourteen patients (62 male) and 73 healthy subjects (38 male) 5 to 20 years of age were analyzed for growth data and current auxology, stage of puberty, and bone age.

Results. Boys with hydrocephalus were shorter than control boys during their first 8 years of age, and no catch-up growth was observed until puberty. Girls with hydrocephalus were of the same size at birth as the control girls, but their linear growth retarded during the first years of life, leading to reduced relative height between the age of 5 to 8 years. The pubertal growth spurt occurred earlier in boys with hydrocephalus (age at midgrowth spurt, 12.1 vs 13.3 years), and a similar trend was seen in girls (10.0 vs 10.7 years). The final height was again reduced, especially in boys. Patients with hydrocephalus were more obese than control subjects, girls more often than boys. Relative bone age was retarded in prepubertal (-0.42 vs 0.32 SD) and accelerated in pubertal patients (0.54 vs -0.19 SD).

Conclusions. Children with hydrocephalus experience slow linear growth in prepuberty, but they have an earlier adolescent growth spurt. Together these factors result in a reduced final height. An increase in relative weight emerges in the preadolescent period, and this phenomenon is accentuated after puberty, leading to an increased prevalence of obesity.

Submitted on August 1, 1994
Accepted on September 26, 1994




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 Arch. Dis. Child.Home page
T. Löppönen, A.-L. Saukkonen, W. Serlo, P. Tapanainen, A. Ruokonen, and M. Knip
Reduced levels of growth hormone, insulin-like growth factor-I and binding protein-3 in patients with shunted hydrocephalus
Arch. Dis. Child., July 1, 1997; 77(1): 32 - 37.
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