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Growth charts of Turkish children with Down syndrome
Beyhan Tüysüz1, Nilüfer Topal Göknar, Birol Oztürk
1Cerrahpasa Medical Faculty, Department of Pediatric Genetics, Istanbul University, Istanbul, Turkey. beyhan@istanbul.edu.tr
Insights
Growth charts for Turkish children with Down syndrome (DS) reveal reduced final height and head circumference compared to national standards. Congenital heart disease impacted weight in early childhood, but not final height or head circumference.
Area of Science:
- Pediatrics
- Genetics
- Endocrinology
Background:
- Down syndrome (DS) is associated with growth abnormalities.
- Understanding growth patterns and influencing factors is crucial for managing children with DS.
Purpose of the Study:
- To establish growth curves for Turkish children with Down syndrome (DS) aged 0-18 years.
- To investigate the impact of congenital heart disease (CHD) and hypothyroidism on growth in DS.
Main Methods:
- Longitudinal data collection of height, weight, and head circumference (HC) for 1,726 Turkish children with DS.
- Growth curve analysis using Cole's LMS method.
- Assessment of major malformations, including CHD, and hypothyroidism status.
Main Results:
- Mean birth length was -0.5 SD below Turkish standards.
- Final height was significantly reduced (-3.06 SD for girls, -2.56 SD for boys).
- Head circumference (HC) fell below -2 SD after 6 months, with final values of -1.02 SD (boys) and -2.21 SD (girls).
- Severe CHD was associated with decreased weight in the first 4 years but did not significantly affect final height or HC.
- Hypothyroidism showed no significant impact on growth.
Conclusions:
- Turkish children with DS exhibit distinct growth patterns, with reduced final height and head circumference.
- Severe CHD may influence early weight but not overall linear growth or head size in DS.
- Hypothyroidism does not appear to be a significant factor affecting growth in this population.
Abstract:
We present growth curves of 1,726 Turkish children with Down syndrome (DS) between 0 and 18 years of age and investigate the factors that affect growth including congenital heart disease (CHD) and hypothyroidism. Longitudinal measurements of height, weight, and head circumference (HC) were assessed and accompanying major malformations were recorded. Growth curves were monitored using Cole's LMS method. The mean birth length was reduced by -0.5 standard deviation (SD) for Turkish standards in both boys and girls. Pubertal growth spurt of the girls with DS started 1 year earlier, their puberty duration was short and pubertal annual growth rate was inadequate, and as a result the final height was -3.06 SD for Turkish standards. Although the age at onset of pubertal growth spurt and puberty duration of the boys were similar to normal population, their pubertal annual growth rate was inadequate; thus the final height was -2.56 SD for Turkish standards. The final weight values were similar to normal population. The mean HC values of DS children were corresponded to -0.9 SD for Turkish standards at birth; however after 6 months values were below -2 SD. The final HC values were -1.02 SD for boys and -2.21 SD for girls for Turkish standards. We observed that weight was decreased in DS children with severe CHD during first 4 years of life. However, there is no statistically significant difference in values of height and head circumference between patients with or without severe CHD group. In addition, hypothyroidism had no effect on growth in DS patients.
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