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PubMed2006

Thrombotic thrombocytopenic purpura associated with von Willebrand factor-cleaving protease (ADAMTS13) deficiency in children.

The physiopathology of thrombotic thrombocytopenic purpura (TTP) has been clarified since 1998, when it was shown that TTP in adults was most often associated with an acquired deficiency of von Willebrand factor-cleaving protease (ADAMTS13) due to autoantibodies, whereas TTP in children was most often associated with a hereditary autosomal recessive severe deficiency of ADAMTS13. The hereditary form of TPP (Upshaw-Schulman syndrome) is a very rare but life-threatening disease if adequate treatment (plasma therapy) is not administered. First manifestations occur before age 10 in two thirds of cases and as soon as birth in most cases. The subsequent course is characterized by recurrent hemolytic and thrombocytopenic crises, with intervals between relapses from every 3 to 4 weeks in two thirds of cases to several months or years in one third of cases. TTP crises are associated with cerebral vascular accidents in at least 30% of patients, with a risk of neurologic sequelae in approximately 20% of patients. Renal involvement includes frequent acute renal failure due to hemoglobinuria and/or thrombotic microangiopathy during hemolytic crisis and progressive renal deterioration in approximately 50% of cases, leading to chronic or end-stage renal failure in approximately 20% of patients. The clinical phenotype may vary from the typical congenital recurrent TTP. Some mild forms are limited to a fluctuating thrombocytopenia and may be misdiagnosed as idiopathic thrombocytopenic purpura. Phenotypic variability may be observed within a single family, which suggests a role of modifier genes. Fresh frozen plasma (FFP) replaces active ADAMTS13. Ten milliliters per kilogram FFP every 2 to 4 weeks suffices to maintain remission. FFP infusions are best used preventively, given that rescue infusions may not prevent central nervous system and renal involvement. It is hoped that plasmatic or recombinant purified ADAMTS13 will be available in the years to come.

ADAM Proteins↗

PubMedDate not supplied

[Congenital metabolic diseases as a cause of acute illnesses in the neonatal period].

Inborn errors of metabolism occurring in the neonatal period both comprise diseases with clinical onset immediately after birth and diseases with clinical onset after a symptom free interval. Organ damage caused by inherited metabolic diseases can occur already in utero or--depending on oral food intake--during the first postnatal days. Unselective screening methods are applied in neonatal mass screening programs for the early detection of metabolic diseases. In cases of unspecific clinical symptoms selective screening procedures may provide an effective diagnostic tool. If a patient with suspected metabolic disease dies, body fluids and organ biopsies should be preserved for further investigations. The establishment of a genotypspecific (enzyme) diagnosis needs time and cost consuming biochemical procedures. It is a prior condition for prenatal diagnosis in further pregnancies.

Female↗

PubMed1990

Cutaneous malignant melanoma in females: the role of hormonal and reproductive factors.

The role of hormonal and reproductive factors as risks for cutaneous malignant melanoma (CMM) was explored by means of a population-based case-control study conducted in Turin, north-western Italy, on 186 female CMM cases and 205 controls. Past use of oral contraceptives (OC) did not seem to exert any effect on CMM risk odds ratio (OR) = 1.12, 95% confidence interval (CI): 0.56-2.24). No association was found even for the longest duration of use, for superficial spreading melanoma cases and for CMM of lower limbs only. While age at first birth did not affect CMM risk, women who had had three or more children seemed to be significantly protected as compared to nulliparous ones. The association was, however, substantially diminished by adjustment for education and other CMM risk correlates (OR for at least three children versus none = 0.62; 95% Cl: 0.29-1.31).

Adolescent↗

PubMed1992

Mortality from ovarian cancer among women with many children.

The exposure range for number of children as a risk factor for ovarian cancer has been severely restricted in most studies. This study is the first to describe the effect of many children, i.e. six or more, on the risk for death from ovarian cancer. The association between number of children in the current marriage given at the Norwegian Census in 1970 and mortality from ovarian cancer was investigated in a prospective study of 800,814 women followed over 15 years. Among postmenopausal women a strong negative trend between number of children and mortality from ovarian cancer was found; women with 8-11 children had a relative risk (RR) of 0.30 (95% confidence interval (CI): 0.17-0.54). For postmenopausal women the rate differences according to parity were constant across age strata indicating an additive model. No significant effect was found for age at first birth or social class. The study indicates that low parity could be the major risk factor for death from postmenopausal ovarian cancer.

Adult↗

PubMed2002

Heterosis and recombination effects on pig growth and carcass traits.

The primary objective was to estimate breed, heterosis, and recombination effects on growth and carcass traits of two different four-breed composite populations of pigs. Experiment 1 (Exp. 1) included purebred and crossbred pigs originating from Yorkshire, Landrace, Large White, and Chester White breeds, and Experiment 2 (Exp. 2) included pigs from Duroc, Hampshire, Pietrain, and Spot breeds. Data were recorded on purebred pigs, two-breed cross pigs, and pigs from generations F1 through F6, where F1 pigs were the first generation of a four-breed cross. Pig weights were recorded at birth and at 14, 28, 56, 70, and 154 d of age. Average daily gain was calculated for intervals between weights, and ultrasonic backfat measurements (A-mode) were taken at 154 d of age. Feed intake was measured between 70 and 154 d of age on mixed pens of boars and barrows. Carcass backfat, length, and loin muscle area were measured on barrows at slaughter. Mixed-model analyses were done separately by experiment, fitting an animal model. Fixed effects included farrowing group and sex for growth traits and farrowing group for carcass traits. For ADFI, a weighted mixed-model analysis was done fitting farrowing group as a fixed effect, sire nested within farrowing group as a random effect, and weighting each observation by the number of pigs in each pen. To test feed efficiency, a second analysis of ADFI was done adding ADG as a covariate in the previous model. Included as covariates in all models were direct, maternal, and maternal grandam breed effects, direct and maternal heterosis effects, and a direct recombination effect. Recombination is the breakup of additive x additive epistatic effects present in purebreds during gamete formation by crossbred parents. Effects of direct heterosis significantly increased weights at birth, 14, 56, 70, and 154 d of age in Exp. 1. Effects of direct heterosis significantly increased ADG from birth to 14, 28 to 56, and 70 to 154 d of age in Exp. 1. In Exp. 2, effect of direct heterosis significantly increased weights and ADG at all ages. In Exp. 1, recombination significantly reduced loin muscle area. In Exp. 2, recombination significantly increased weights at birth, 14, 28, and 56 d, ADFI from 70 to 154 d, and ADFI adjusted for ADG. The correlation between maternal heterosis and recombination effects for all traits in Exp. 1 and Exp. 2 was approximately -0.90. Maternal heterosis and recombination effects were estimable, but greatly confounded.

Adipose Tissue↗

PubMedDate not supplied

Biomedical pattern discrimination of neonatal cardiovascular risk.

Genetic risk is a primary contributing factor to the predisposition of a newborn child to elevated blood pressure later in life. An index for this factor is needed to assess in the neonate the success or failure of preventive interventions instituted for the pregnant woman. This index could be based on characteristics describing the variability of blood pressure and heart rate during the first days after birth. In the search for such an index, the systolic and diastolic blood pressures and heart rates of 150 newborn babies were automatically monitored at about 30-minute intervals for 48h with a Nippon Colin device, starting early after birth. On the basis of questionnaires given to the parents, the neonates were assigned to a group of either a negative or positive family history of high blood pressure, according to the absence or presence of high blood pressure and/or related cardiovascular disease in two generations (those of the newborn's parents and grandparents). Circadian characteristics and descriptive statistics for the three circulatory variables were used for classification by a so-called "monotest", an all-subsets variable selection technique for biomedical discriminant analysis. For a particular combination of variables, the "monotest" performs as many steps of separate analyses as the total number of subjects, each subject's data being compared as a set with those of all others ("leave-one-out" approach). When the circadian amplitude of systolic blood pressure was used as classifier, the "monotest" yielded a 63% classification equivalent to prior criteria, the latter being based on a negative or a positive family history of high blood pressure. The "monotest" complements rhythmometric procedures and defines a set of individualized criteria for risk assessment. The combined use of automatic hardware for time-specified sampling with proper software for signal processing and discriminant analysis allows to recognize parameters of blood pressure circadian variability as a source of information for neonatal classification according to cardiovascular disease risk.

Blood Pressure↗

PubMed1994

Hemolytic complement activity and concentrations of its third component during maturation of the immune response in colostrum-deprived foals.

Six foals were deprived of colostrum for the first 36 hours after birth and, instead, received reconstituted powdered milk. Five control foals suckled their dams naturally. Blood samples were obtained from all the foals after birth and at approximately weekly intervals until at least 5.5 months of age. Sera were analyzed for hemolytic complement activity, complement component C3, and correlating IgG concentration. Hemolytic complement (P = 0.0145) and C3 (P = 0.0002) values were significantly higher in colostrum-deprived foals (CDF) than in naturally nursed foals at 2 to 5 days of age. In addition, significantly (P = 0.0149) higher IgG concentration was found in CDF than in naturally nursed foals between 3 and 5.5 months of age. It was concluded that the observed high complement activity in CDF within 2 to 5 days of age may provide an alternative in immune defense for IgG-deprived foals after failure of colostral transfer.

Aging↗

PubMed1993

Randomized trial of silver nitrate, erythromycin, and no eye prophylaxis for the prevention of conjunctivitis among newborns not at risk for gonococcal ophthalmitis. Eye Prophylaxis Study Group.

OBJECTIVE: To compare the efficacy of commonly used forms of eye prophylaxis for newborns with no prophylaxis in the prevention of nongonococcal conjunctivitis. DESIGN: Randomized doubly masked clinical trial. SETTING: University of Washington Hospital and affiliated clinics, Seattle, between 1985 and 1990. SUBJECTS: The medical records of 8499 women were evaluated for possible participation; 2577 were eligible. Of the 758 enrolled, the infants of 630 were evaluable. INTERVENTION: Comparison of silver nitrate, erythromycin, and no eye prophylaxis given at birth for the prevention of conjunctivitis. MAIN OUTCOME MEASURES: Conjunctivitis during the first 60 days of life and nasolacrimal duct patency in the first 2 days of life. RESULTS: The frequency of impatent tear ducts at the 30- to 48-hour examination did not differ significantly by prophylaxis group. Among the 630 infants randomized and observed, 109 (17%) developed mild conjunctivitis. Sixty-nine (63%) of the cases appeared during the first 2 weeks of life. After 2 months of observation, infants allocated to silver nitrate eye prophylaxis at birth had a 39% lower rate of conjunctivitis (hazard ratio = 0.61, 95% confidence interval = 0.39 to 0.97), and those allocated to erythromycin had a 31% lower rate of conjunctivitis (hazard ratio = 0.69, 95% confidence interval = 0.44 to 1.07), than did those allocated to no prophylaxis. CONCLUSION: Silver nitrate eye prophylaxis caused no sustained deleterious effects and even provided some benefit to infants born to women without Neisseria gonorrhoeae. However, the effect was modest and against microorganisms of low virulence. The results suggest that parental choice of a prophylaxis agent including no prophylaxis is reasonable for women receiving prenatal care and who are screened for sexually transmitted diseases during pregnancy.

Adult↗

PubMed1996

Enzyme replacement with recombinant beta-glucuronidase in murine mucopolysaccharidosis type VII: impact of therapy during the first six weeks of life on subsequent lysosomal storage, growth, and survival.

Treatment of mucopolysaccharidosis type VII (MPS VII) mice with recombinant mouse beta-glucuronidase injections has been shown to deliver enzyme to most tissues and to reduce lysosomal storage during the first 6 wk of life. Here we determine the effect of enzyme therapy limited to the first 6 wk of life on survival and growth and follow the subsequent accumulation of lysosomal storage after beta-glucuronidase treatment is discontinued. MPS VII mice received 28,000 U of beta-glucuronidase i.v. at weekly intervals from birth to 6 wk of life and were killed at intervals up to 1 y after the last injection. By 29 d after the last enzyme injection, lysosomal storage in bone was no different in amount than that seen in untreated MPS VII mice. By 85 d, the fixed tissue macrophage system, meninges, and brain glia had also accumulated storage comparable to that seen in untreated controls. One year after treatment, lysosomal storage was similar to that of untreated MPS VII mice in all sites except cortical neurons, where there was still a slight reduction. All treated mice that were not killed earlier, lived longer, were larger, and had milder facial and skeletal deformities than untreated MPS VII mice. These data show that enzyme replacement therapy in MPS VII mice during the first 6 wk of life improve survival and growth. After treatment is discontinued, storage accumulates slowly in the brain and more rapidly in the fixed tissue macrophage system. Whether therapy continued later in life can further improve survival and growth remains to be established.

Animals↗

PubMed2006

Obstetrics and perinatal outcomes of Thai pregnant adolescents: a retrospective study.

BACKGROUND: Adolescent pregnancy is considered a high risk pregnancy. OBJECTIVES: The purpose of this study was to compare pregnancy outcomes in adolescent females aged 19 and younger with those of adult women aged 20-34 years. DESIGN: A retrospective case control study was designed to address the purpose of the study. PARTICIPANTS: Participants of this study consisted of 401 randomly selected adolescent females and 815 adult mothers who gave birth at a regional hospital in Bangkok from 2001 to 2003. METHODS: Two domains of pregnancy outcomes; maternal and infant outcomes were collected from participants' medical and prenatal records by trained observers. RESULTS: The study revealed that, compared to the adult mothers, teenage mothers were less likely to make the first prenatal visit in their first trimester (16% and 38.9%, p<.001), to have adequate prenatal care (83% and 91%, p<.01), and cesarean sections (odds ratio (OR) 2.05, confidence interval (CI) 1.44, 2.92). They had higher rates of anemia (OR 0.44, CI 0.26, 0.75), preterm deliveries (OR 1.21, CI 1.01, 1.75), and lower mean birth weight babies (2931 g and 3077 g, p<.001). CONCLUSION: This study demonstrates that, while teenage pregnancy outcomes have improved in recent years due to medical accessibility, pregnant adolescents continue to be complicated requiring clinical interventions from the health care providers.

Adolescent↗

PubMed2003

Anemia during pregnancy in a Chinese population.

OBJECTIVES: To study prevalence, risk factors, and birth outcomes of women with anemia during pregnancy in a Chinese population. METHODS: A retrospective cohort study was performed based on 16936 pregnancies delivered between January 1989 and December 1990 in Suzhou, China. Anemia was defined as hemoglobin less than 10 g/dl. Multivariate logistic regression was used to estimate odds ratio, 95% confidence interval, and to control for confounding variables. RESULTS: The prevalence of anemia was 10.3% at the first trimester, 18.9% at the third trimester. Overall, 26.2% pregnant women experienced anemia in pregnancy. Anemia during early pregnancy was not associated with increased risk of adverse perinatal outcomes. However, anemia in later pregnancy was inversely associated with preterm birth and low birth weight. CONCLUSIONS: Anemia during pregnancy does not increase the risk of poor birth outcomes.

Adult↗

PubMedDate not supplied

Association between administration of hepatitis B vaccine at birth and completion of the hepatitis B and 4:3:1:3 vaccine series.

CONTEXT: The association between infant age at initiation of hepatitis B vaccination and completion of the 3-dose hepatitis B vaccination series is unclear. OBJECTIVE: To assess the association between administration of the first dose of hepatitis B vaccine within 7 days of birth and completion of the hepatitis B vaccine series and the 4:3:1:3 vaccine series (4 doses of diphtheria-tetanus-pertussis vaccine, 3 doses of polio vaccine, 1 dose of measles-containing vaccine, and 3 doses of Haemophilus influenzae type b vaccine). DESIGN, SETTING, AND PARTICIPANTS: Analysis of data from the 1998 National Immunization Survey, a random-digit-dialing telephone survey (n = 34,480 completed interviews) of parents of children aged 19 to 35 months from 50 states and 28 selected urban areas in the United States that included a provider record check mail survey. MAIN OUTCOME MEASURES: Percentage of infants who received at least 3 doses of hepatitis B vaccine and percentage who received the 4:3:1:3 vaccine series, by age at receipt of the first dose of hepatitis B vaccine. RESULTS: Overall, 86.9% of children 19 to 35 months of age in 1998 received 3 or more doses of hepatitis B vaccine, and 79.9% completed the 4:3:1:3 vaccine series. Multivariate analysis indicated that, compared with children who received the first hepatitis B vaccine dose within 7 days of birth, odds ratios (ORs) for not completing the 3-dose hepatitis B vaccine series among children who received the first dose at 8 to 41 days, 42 to 91 days, 92 to 182 days, 183 to 273 days, and 274 or more days of age were 2.4 (95% confidence interval [CI], 2.0-3.0), 7.8 (95% CI, 6.5-9.3), 9.6 (95% CI, 7.0-13. 3), 18.3 (95% CI, 12.0-28.0), and 46.6 (95% CI, 33.7-64.5), respectively; ORs for not completing the 4:3:1:3 vaccine series among these same groups were 1.0 (95% CI, 0.8-1.1), 1.0 (95% CI, 0. 8-1.1), 1.7 (95% CI, 1.3-2.3), 3.8 (95% CI, 2.6-5.6), and 4.0 (95% CI, 2.9-5.5), respectively. CONCLUSION: Administration of the first dose of hepatitis B vaccine at birth is associated with increased likelihood of completion of the hepatitis B vaccination series. JAMA. 2000;284:978-983

Child, Preschool↗

PubMed1996

History of childbearing and colorectal cancer risk in women aged less than 60: an analysis of Swedish routine registry data 1960-1984.

Data from a computerised linkage between the Swedish Cancer Registry and the Fertility Registry were used to study the influence of reproductive history on the risk of colorectal cancer in women aged less than 60, in the period 1960 to 1984. A "nested" case-control design was used with 1,415 colon cancer cases and 733 rectal cancer cases, and 7,073 and 3,665 age-matched controls, respectively. Conditional logistic regression was employed to study the independent effects of parity, age at first birth and years since last birth on the risk of colorectal cancer. High parity was associated with reduced risk in women older then 50 years at diagnosis, both for the colon as a whole and for colon subsites. Women having had 5 children or more had an odds of colon cancer of 0.44 (95% confidence interval 0.24-0.82) relative to that of nulliparous woman. Contrary to the hypothesis advanced by McMichael and Potter (J. Nat. Cancer Inst., 75, 185-191 [1985]), which predicted a strong protective effect of parity in the proximal compared to the distal colon, we found the reverse. Increasing years since last birth seemed to be associated with a reduced risk of rectal cancer. A significant positive trend with increasing age at first birth was suggested with respect to distal colon cancer and rectal cancer risk. The mutually adjusted effects of the reproductive variables under study were similar to the unadjusted effects. Our data suggest that increasing parity is associated with a decline in risk of colon cancer but not rectal cancer, although the association with colon cancer is restricted to women aged 50 or more. The effects of age at first birth and years since last birth are not consistent or pronounced.

Adult↗

PubMed2004

Gene dose-dependent atrial arrhythmias, heart block, and brady-cardiomyopathy in mice overexpressing A(3) adenosine receptors.

OBJECTIVE: An increased expression of adenosine receptors is a promising target for gene therapy aimed at protecting the myocardium against ischemic damage, but may alter cardiac electrophysiology. We therefore studied the effects of heart-directed overexpression of A(3) adenosine receptors (A(3)ARs) at different gene doses on sinus and atrio-ventricular (AV) nodal function in mice. METHODS AND RESULTS: Mice with heart-specific overexpression of A(3)AR at high (A(3)(high)) or low (A(3)(low)) levels and their wild-type littermates were studied. Telemetric electrocardiogram (ECG) recordings in adult freely moving A(3)(high) mice showed profound sinus bradycardia resulting in either ventricular escape rhythms or an incessant bradycardia-tachycardia syndrome (minimal heart rate A(3)(high) 217+/-25*; WT 406+/-21 beats/min, all values as mean+/-S.E.M., n=7 per genotype, *p<0.05). Exercise attenuated bradycardia in A(3)(high) mice (maximal heart rate A(3)(high) 650+/-13*; WT 796+/-13 beats/min) and first-degree AV nodal block was present (PQ interval A(3)(high) 36+/-4*; WT 23+/-5 ms). Isolated hearts showed complete heart block (10/17 A(3)(high)* vs. 1/17 WT). Atrial bradycardia and AV block were already present 3 weeks after birth. Doppler echocardiography revealed atrial dysfunction and progressive atrial enlargement that was moderate at 3 and 8 weeks, and progressed at 12 and 21 weeks of age (all p<0.05 vs. WT). Atrial contractility and sarcoendoplasmic Ca(2+) ATPase (SERCA) 2a protein expression were reduced in isolated left A(3)(high) atria at the age of 14 weeks. Fibrosis was present in left A(3)(high) atria at 14 weeks, but not at 5 weeks of age. A(3)(low) mice had first-degree AV block without arrhythmias or structural changes. CONCLUSIONS: Heart-directed overexpression of A(3)AR resulted in gene dose-dependent AV block and pronounced sinus nodal dysfunction in vivo. Profound bradycardia heralded atrial and ventricular dilatation, dysfunction, and fibrosis. In contrast to A(1) adenosine receptors (A(1)AR), the effects of A(3)AR overexpression were attenuated during exercise. This may have implications for the physiology of sinus nodal regulation and for therapeutic attempts to increase the expression of adenosine receptors.

Animals↗

PubMed1986

Fatal ureaplasma infection in second twin born 60 days after delivery of the first in a patient with recurrent spontaneous abortion--a case report.

A delay of more than one month between the birth of twins is an unusual occurrence presenting the obstetrician and the neonatalogist with many questions regarding the management of the case. There is the risk of prematurity for the second twin as labor has already occurred in the pregnancy. There is also a risk of infection to both mother and fetus during the interval between the two deliveries, since the stump of the first twin's cord may precipitate ascending colonization from vagina and cervix. Germs frequently recovered from the vagina e.g. Ureaplasma urealyticum, are associated with prematurity. The latter has also been responsible for lethal interstitial pneumonia in the neonate. We present a case of a patient who though she delivered twice normally, had suffered 4 first trimester abortions and one late abortion, all spontaneous. Her eighth pregnancy was a twin pregnancy. She underwent a cerclage at 14 weeks, but went into labor at 17 weeks, when she delivered the first macerated twin. She was then treated with fenoterol and ampicillin; nevertheless she delivered twin the second at 26 weeks. This 750 g baby-girl presented with severe respiratory distress. Repeated chest X rays showed perihilar infiltrates which became nodular. All cultures were negative. At the end of the first week, when her condition was considered satisfactory, she deteriorated dramatically and died in respiratory failure and DIC. Tracheal aspirates were positive for Ureaplasma urealyticum.

Abortion, Habitual↗

PubMed1992

Decreased fecundability in Hutterite couples sharing HLA-DR.

To study the effects of parental HLA sharing on pregnancy outcome, we initiated population-based studies in the Hutterites. We previously reported longer intervals from marriage to each birth among couples sharing HLA, particularly HLA-DR. In the present report, we present the results of a prospective, 5-year study of fecundability and fetal loss rates in this population. Between April 1986 and April 1991, 154 pregnancies were observed in 104 couples. The median number of months of unprotected intercourse to a positive pregnancy test was significantly longer among couples sharing HLA-DR who stopped nursing prior to the first menses as compared with couples not sharing HLA-DR who stopped nursing prior to the first menses (5.1 vs. 2.0 mo, respectively; P = .016). Fetal loss rates were increased among couples sharing HLA-B as compared with couples not sharing HLA-B (.23 vs. .12, respectively; P = .041, adjusted for age, gravidity, and kinship). These data suggest that our earlier observations of increased birth interval lengths among Hutterite couples sharing HLA were predominantly due to longer intervals until a clinical pregnancy among couples sharing HLA-DR and, to a lesser degree, were due to increased fetal loss rates among couples sharing HLA-B.

Abortion, Spontaneous↗

PubMed1992

Time interval in twin delivery--the second twin need not always be born shortly after the first.

In order to evaluate the influence of the time interval on the second twin in twin deliveries, we have used more precise criteria than have been used in the literature to date. The following parameters of the twins were analyzed: normal CTG of the second twin recorded continuously during labor and pH value of the umbilical artery blood after delivery as well as clinical state according to the modified Apgar score. We could not find a general influence of the time interval on pH and clinical status of the second twin. Our results indicate that in cases of uncomplicated twin delivery with a normal cardiotocogram there is no necessity for the second twin to be born as soon as possible after the birth of the first twin.

Acid-Base Equilibrium↗

PubMed1996

Growth charts for prepubertal children with chronic renal failure due to congenital renal disorders. European Study Group for Nutritional Treatment of Chronic Renal Failure in Childhood.

Despite the high prevalence of and therapeutic attention to growth failure in children with chronic renal failure (CRF), systematic evaluations of spontaneous growth in CRF are lacking. Therefore, we collected retrospectively longitudinal growth and biochemical data in 321 prepubertal patients treated for CRF due to congenital renal disorders. Data were recorded at 3-month intervals during the first 2 years of life and 6-monthly thereafter, up to the age of 10 years. Around 100 measurements were available per age interval. Mixed-longitudinal percentile curves of height and height velocity were constructed. Moreover, a statistical comparison with the heights and height velocities of healthy children and an evaluation of the effect of biochemical parameters on growth was performed. The CRF children had normal heights at birth but dropped below the 3rd normal percentile during the first 15 months of life. Thereafter, growth patterns usually were percentile parallel, with a mean height standard deviation score (SDS) of -2.37 +/- 1.6. Height velocities were consistently lower in patients with glomerular filtration rates (GFRs) below one-third of the lower normal limit (25 ml/min per 1.73 m2 for patients > 1 year) than in patients with better renal function. This difference in growth rates resulted in a mean height SDS of -1.65 +/- 1.5 SDS and -2.79 +/- 1.4 SDS (age 1-10 years) in the subgroups with relatively better and worse GFR, respectively. Regression analysis confirmed that GFR was a weak but significant predictor of height velocity SDS in most age groups.

Child↗