Growth deceleration patterns in children with constitutional short stature: an aid to diagnosis.

A retrospective study of 263 children referred for evaluation of short stature revealed that 149 (56.7%) had constitutional short stature (CSS). A typical pattern of growth was observed in these children. As exemplified by 12 children who had complete serial growth measurements, exaggerated growth deceleration first became apparent between 3 and 6 months of age, was greatest in the first two years of life, and resulted in these children falling more than 2 SDs below the mean for height by 3 years of age. After 3 years of age, the growth rate of these children with CSS was essentially the same as that of normal children, and they ran parallel to the growth curve though below the third percentile. The importance of serial measurements and the growth chart is emphasized, and recommendations are made for the evaluation of short stature or abnormal growth deceleration in the first three years of life. Awareness of this typical pattern of growth in children without disease may aid the pediatrician in his evaluation of short stature and allow for watchful waiting when results of screening tests are normal.