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Bone age and growth in fetal alcohol syndrome
B F Habbick1, P M Blakley, C S Houston
1Alvin Buckwold Child Development Program, Kinsmen Children's Centre, Royal University Hospital, Saskatoon, Saskatchewan, Canada.
Insights
Children with fetal alcohol syndrome (FAS) show delayed bone age, suggesting potential for growth. However, studies indicate persistent short stature into adulthood, with significant changes in weight and head circumference Z-scores.
Area of Science:
- Pediatrics
- Endocrinology
- Genetics
Background:
- Fetal alcohol syndrome (FAS) is a leading cause of preventable birth defects.
- Growth patterns in children with FAS are not fully understood, particularly long-term outcomes.
- Delayed bone age has been observed in children with FAS, prompting investigation into growth potential.
Purpose of the Study:
- To investigate bone age and long-term growth patterns in children diagnosed with fetal alcohol syndrome.
- To assess if delayed bone age in FAS correlates with catch-up growth or persistent short stature.
- To evaluate changes in height, weight, and head circumference from childhood to adulthood in FAS patients.
Main Methods:
- Retrospective analysis of bone age and anthropometric data (height, weight, head circumference) in 63 children with FAS.
- Comparison of Z-scores for bone age, height, weight, and head circumference at different age points.
- Longitudinal follow-up of 26 patients until late adolescence/early adulthood (females ≥14 years, males ≥16 years).
Main Results:
- Mean bone age Z-scores were significantly delayed in both boys (-2.12 SDs) and girls (-1.62 SDs) with FAS.
- Height Z-scores showed no significant change from childhood (mean -2.16 SDs) to adulthood (mean -2.11 SDs), indicating persistent short stature.
- Significant improvements were observed in weight (Z-score from -2.10 to -1.14) and head circumference (Z-score from -3.13 to -2.63) over time.
Conclusions:
- Delayed bone age in fetal alcohol syndrome may not predict catch-up growth and is associated with persistent short stature.
- Weight and head circumference show catch-up growth, but height remains significantly reduced into adulthood.
- Short stature remains a reliable diagnostic criterion for FAS beyond childhood.
Abstract:
We have found delayed mean bone age in 63 children with fetal alcohol syndrome (FAS). The mean bone age Z-score for boys (n = 31) was -2.12 SDs and for girls (n = 32) was -1.62 SDs. This might suggest that they have potential for catch-up growth. However, experience with children with intrauterine growth retardation suggests that this will not be the case and that FAS children will be of reduced height at maturity. Further support for this assumption was gained from a sample of 26 patients who were followed until at least the age of 14 years for females and 16 years for males. There was no significant change in height Z-scores from early childhood to early adulthood, the mean score being -2.16 SDs and -2.11 SDs at mean ages of 4.83 years and 18.69 years, respectively. On the other hand, there were significant changes in weight and head circumference. The mean weight Z-score changed from -2.10 SDs to -1.14 SDs (p < 0.001). The head circumference mean Z-score in 16 patients was -3.13 SDs at a mean age of 2.79 years and -2.63 SDs at a mean age of 17.37 years (p = 0.013). Short stature can continue to be used as a diagnostic criterion for FAS beyond childhood.
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