Identification of a child with short stature

Abstract

The objective of this study was to determine the utility of Indian Council of Medical Research's (ICMR) height percentile standards in comparison to Tanner's, in the evaluation of children with short stature. The study consisted of an initial survey of the heights of 500 consecutive new cases brought to the Out Patient Department. The heights were assessed by both ICMR and Tanner's standards. Only 10% were below the 5th percentile of ICMR standards while as many as 32% were below the 3rd percentile of Tanner's standards. Two hundred children who were referred to the endocrine clinic primarily for short stature and who were below the 3rd percentile of Tanner's standards were then evaluated. Of these 200 short children 132 (66%) were also below the 5th percentile of ICMR standards. The major causes of short stature in those below the 5th percentile of ICMR standards were endocrine (56.8%). In the group between the 5th percentile of ICMR standards and 3rd percentile of Tanner standards the major cause of growth retardation was normal variant short stature (67.8% of cases in this group). Correlation of the child's height with the mid-parental height was seen in 90.4% in this group but in only 16.6% of those below the 5th percentile of ICMR standards. The ICMR standards may, therefore, be more suitable than Tanner's standards for the identification of a short child from the lower socio-economic groups.