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Medically underserved girls receive less frequent evaluation for short stature
Date:3/21/2011

altering, with boys comprising 53 percent of that group. Children with growth faltering had more tests than the others in the study, and boys were more likely to be tested for deficiencies of the growth hormone system than girls.

Children who saw subspecialists had greater deficits in stature and were seen more frequently by primary care providers than were children who were not referred to specialists. Children who saw gastroenterologists were the same age as those who were not referred to subspecialists; however, children who saw endocrinologists were on average two to three years older.

Black children were less likely to see a subspecialist than white children and the disparity was greater for endocrinology than gastroenterology. Subspecialty care was not associated with gender or type of insurance.

Only 1 percent of the girls with growth faltering received chromosome testing. They were more likely to have this test than boys because Turner syndrome is a genetic condition that leads to a reduction in height and occurs in girls only. Thirty-five percent of the girls tested were at least 12 years old.

"Timely diagnosis is important for the initiation of proper monitoring and treatment of syndrome- associated complications such as renal and cardiac malformations, neurosensory hearing loss, and neurocognitive issues. It is particularly concerning that 35 percent of the girls with growth faltering and chromosome testing were already at least 12 years old," added Dr. Grimberg.

This study builds on previous work by Dr. Grimberg, published in 2005, that found a gender bias among children receiving evaluation for short stature in subspecialty clinics.

"While social pressures for tallness may be greater in boys than girls, primary care providers who overlook growth faltering may be missing out on an underlying condition that has additional health consequences. Height is the clue, not the endgame," said Dr. Grimberg. <
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Contact: Joey McCool Ryan
McCool@email.chop.edu
267-426-6070
Children's Hospital of Philadelphia
Source:Eurekalert

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