Medically underserved girls receive less evaluation for short stature

Area of Science:

• Pediatric Endocrinology
• Growth Disorders
• Diagnostic Evaluation

Background:

• Growth-faltering is a common concern in pediatric primary care.
• Early and accurate diagnosis is crucial for appropriate management of growth disorders.

Purpose of the Study:

• To investigate potential gender-based disparities in diagnostic evaluations for children experiencing growth-faltering.
• To determine if primary care pediatricians' diagnostic approaches differ by gender in children with growth-faltering.

Main Methods:

• Retrospective analysis of 33,476 children from urban pediatric primary care practices.
• Growth-faltering defined by height percentile or z-score decrease.
• Examined height z-score, age, gender, diagnostic tests, and subspecialist referrals.

Main Results:

• 3007 children (9%) had growth-faltering.
• While overall subspecialty care was not gender-associated, chromosome testing was more frequent in short girls (1.4%) vs. boys (0.4%).
• Growth hormone/insulin-like growth factor axis testing was more common in short boys (1.8%) vs. girls (0.9%).

Conclusions:

• Diagnostic testing patterns for growth-faltering may differ by gender.
• These differences could contribute to underdiagnosis of conditions like Turner syndrome and growth hormone deficiency in girls.
• Further research is needed to ensure equitable diagnostic evaluation for all children.