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Growth curves of Dutch children with Down's syndrome
M J Cremers1, I van der Tweel, B Boersma
1Department of Medical Physiology and Sports Medicine, University of Utrecht, The Netherlands.
Insights
Dutch children with Down syndrome have distinct growth patterns. They are taller than US peers but shorter than typical Dutch children, with higher weight for height after age 10.
Area of Science:
- Pediatrics
- Genetics
- Human Growth and Development
Background:
- Down syndrome (DS) is a genetic disorder affecting physical and cognitive development.
- Establishing accurate growth references is crucial for monitoring the health of children with DS.
- Existing growth charts may not adequately represent the unique growth trajectory of children with DS.
Purpose of the Study:
- To develop age-specific reference charts for height and weight in Dutch children with Down syndrome.
- To compare the growth patterns of Dutch children with DS to their US counterparts and to typical Dutch children.
- To assess the validity of cross-sectional data for representing longitudinal growth in this population.
Main Methods:
- Collected 2,045 height and weight observations from 295 healthy Dutch children with Down syndrome (ages 0-20 years).
- Performed cross-sectional analysis to calculate smoothed mean and standard deviation per age class.
- Utilized quadratic regression on longitudinal data from a subgroup to validate cross-sectional findings.
Main Results:
- Developed smoothed age references for height and weight for Dutch children with Down syndrome (0-20 years).
- Dutch children with DS are taller than US peers (P50 ≈ US P75) but over 2 SD shorter than typical Dutch children.
- Mean weight-for-height in children with DS exceeds the P90 of normal children after age 10.
Conclusions:
- The developed reference curves accurately represent growth in Dutch children with Down syndrome.
- Children with Down syndrome exhibit unique growth patterns compared to both US peers and typical Dutch children.
- Monitoring weight-for-height is important for children with Down syndrome, especially after age 10, due to potential obesity risks.
Abstract:
Two thousand and forty-five observations on height and weight were collected from 295 healthy Dutch children with Down's syndrome. In a cross-sectional analysis, means and standard deviations were calculated per age-class, and subsequently smoothed, resulting in age references between 0 and 20 years. Each child contributed only once in every age class. In a subgroup in whom more than four measurements were available before puberty, quadratic regression functions were determined on the basis of the full data set, as well as for individual children separately (54 boys and 25 girls). The average coefficients of the individual regression functions were almost identical to the coefficients of the regression line through all data, indicating that the reference curve for the mean height based on cross-sectional analysis adequately represents longitudinal growth during childhood. Dutch children with Down's syndrome are taller than their US peers (P50 equals P75) but more than 2 SD shorter than normal Dutch children. Above the age of 10 years, the mean weight for height is above the P90 of normal children.