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The Auxology of Growth Delay

Growth delay is the commonest cause of short stature, especially in boys, accounting for 26% of patients seen in the Growth Clinic of the Hospital for Sick Children. Despite the good prognosis the disorder causes much unhappiness and concern.Growth and pubertal development were studied in detail in 315 boys in the age range 2 to 21 years. Mixed longitudinal analysis showed a concordant delay of body measurements and skeletal maturity, apparent from the earliest ages. Pubertal development was comparably delayed. Forty boys were followed until mature height was reached (less than 1 cm gained over the last year). In these, mature height averaged 164.0 cm (-1.7 SDS) with 10th and 90th centiles at 155 and 168 cm. Mean height prediction (TW2-RUS) made at first clinic visit (mean age 13.7; SD 2.9 years) was 161.7 and was therefore unduly pessimistic. The mean height of fathers (mostly reported) was 172.7 cm, (-0.3 SDS) and of mothers 160.5 cm, (-0.3 SDS). We suppose that selection for attendance at the clinic accounts for most or all of the discrepancy between heights of sons and parents; their small sons attend, their tall ones do not. Correlation of the patients' mature heights with fathers' heights was 0.55; with mothers' 0.22: neither were significantly different from the theoretical 0.5.