Girls may be undertreated for short stature

New research indicates a possible gender bias in referrals for evaluation of short stature, such that the problem could be overlooked in girls and overtreated in boys.

"Growth failure is a very sensitive indicator of a child's overall health, and should be evaluated with equal care for both boys and girls," lead author Dr. Adda Grimberg, from The Children's Hospital of Philadelphia, said in a statement. In actuality, "referral patterns may result from social pressures implying that short stature is a more significant problem in boys than girls."

The findings, which appear in the Journal of Pediatrics, are based on a review of all short stature referrals seen at the authors' institution in 2001.

During the study period, a total of 182 boys and 96 girls were referred. However, the height deficit in girls, compared with the general population and parent height, was significantly greater than that seen in boys.

Although not statistically significant, girls took longer to be referred for short stature than boys did. The average time from falling off the growth curve to referral was 35 months for girls versus 24 months for boys.

Forty-one percent of girls had an organic basis for their short stature compared with just 15 percent of boys. Moreover, just 48 percent of girls were of normal height or short but healthy compared with 72 percent of boys.

Gender as well as short stature severity had no bearing on pre-referral test frequency, the investigators note.

"Sex differences in short stature referrals may delay diagnosis of diseases in girls while promoting overzealous evaluations of healthy boys who do not appear to be tall enough," the authors conclude.

SOURCE: Journal of Pediatrics, February 2005.