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Growth and sexual development in children with meningomyelocele
Insights
Children with meningomyelocele (MMC) exhibit significant growth delays and advanced skeletal maturation. These findings highlight crucial developmental differences in pediatric patients with spinal defects.
Area of Science:
- Pediatric Endocrinology
- Developmental Biology
- Pediatric Neurology
Background:
- Meningomyelocele (MMC) is a complex congenital condition requiring early surgical intervention.
- Hydrocephalus is a common comorbidity in MMC patients, necessitating cerebral drainage.
- Understanding the long-term growth and developmental trajectory in MMC is essential for patient care.
Purpose of the Study:
- To assess growth, skeletal maturation, and pubertal development in children with meningomyelocele.
- To compare these parameters with age-matched healthy children.
- To identify specific growth patterns and developmental deviations associated with MMC.
Main Methods:
- Cross-sectional study involving 45 children (25 girls, 20 boys) with surgically treated meningomyelocele.
- Measurement of height, sitting height, sub-ischiac leg length, head circumference, weight, and bone age.
- Comparison of standard deviation scores (SDS) with data from a normal Swiss population.
Main Results:
- Children with MMC were significantly shorter, with decreased trunk and lower limb length, but normal arm length.
- Head circumference was increased, particularly in girls. Weight was decreased, yet relative obesity was suggested when considering height.
- Bone age was significantly advanced in both sexes. Pubertal development and secondary sex characteristics appeared early, with cryptorchidism noted in 25% of boys.
Conclusions:
- Children with meningomyelocele display distinct growth patterns, including short stature and advanced skeletal maturation.
- Early pubertal development and specific anthropometric changes are characteristic of this population.
- These findings underscore the need for specialized monitoring of growth and development in children with MMC.
Abstract:
Forty-five children (25 girls; 20 boys) with meningomyelocele (MMC) were assessed for growth, skeletal maturation and pubertal development. The spinal defects were operated on shortly after birth and all children required cerebral drainage for hydrocephalus. Standard deviation scores for height, sitting height, sub-ischiac leg length, head circumference, weight and bone age were compared with aged-matched data from a normal Swiss population. The children with MMC were shorter (height SDS boys -2.34 +/- 1.57; girls -2.01 +/- 1.57, mean +/- SD, P less than 0.0005), secondary to a decrease in trunk and lower limb length: Arm length was normal. The head circumference was increased, significantly in the girls (SDS + 1.49 +/- 1.21, P less than 0.005). Weight was decreased in both sexes, this being significant in the boys (SDS -1.11 +/- 1.23, P less than 0.005); however, comparison of weight with height suggested that children with MMC were relatively obese. Bone age was significantly advanced in both boys (SDS + 1.07 +/- 2.13, P less than 0.025) and girls (SDS + 1.36 +/- 1.77, P less than 0.0001). Secondary sex characteristics appeared early in both boys and girls and one girl and one boy presented with puberty advanced by several years. Cryptorchidism occurred in 25% of boys with MMC.