The Final Phase of Growth in Stature - GGH Journal

1.5 cm for males and 1.0 cm for
females.1 The final phase of
growth in stature probably reflects
elongation in the vertebral column.
Increments after Peak Height
Velocity (PHV) and Menarche
The distributions of the total increments
after PHV are slightly larger
for boys than for girls, with large
differences between the 10th and
90th percentile levels in each sex
(Table 2). These sex-associated
differences are particularly large
for the first year after PHV. The
annual increments decrease rapidly
after PHV, with almost as much
growth in the first year as in the
second to fifth years combined.
The data for annual increments
after PHV do not add up to the total
increments, because the groups
for the annual increments differ
across intervals. It is noteworthy
that at least 10% of the boys and of
the girls had increments greater
than 1.0 cm even from 4 to 5 years
after PHV.
The median total stature increment
after menarche was 7.4 cm
with a 10th to 90th percentile range
from 4.3 to 10.6 cm. These findings
are in agreement with reports of
growth from menarche to the end
of school attendance or to 18.25
years.6.? The median increments
during the first year after menarche
exceeded the sum of the
median annual increments over
the next 4 years.
Relationships to the Timing of
PHV and Menarche
The later the occurrence of PHV
and menarche, the lesser the
growth in stature after these
events 1,4,8,9 (Figure), After PHV,
there was considerably more
growth in boys than in girls for
groups matched in age at PHV, but
the ranges from the 5th to the 95th
percentiles and the slopes of the
regressions were almost identical
in each sex, The increments in
boys from 14 to 17 years are also
negatively related to stature at 14
years,10
Clinical Applications
The preceding data may serve as
guides to the potential for growth in
stature, depending on the patient's
maturational status. This information
therefore may assist decisions
about the initiation or
cessation of therapy. Such decisions
will be influenced as well by
the presence and nature of any
pathological condition and by the
attitude of the patient and the patient's
family.
More complex procedures utilize
regression equations to pre-
dict adult stature from childhood
variables.3.11,12 These require assessments
of skeletal age and,therefor
cannot be used after
maturation of the hand-wrist is
complete. Prediction methods
based on regression are likely to
be misleading when applied to
children with chronic diseases that
affect growth, with large overpredictions
more likely than underpredictions.
The Bayley-
Pinneau method13 is the best current
procedure for predicting the
adult statures of children with diseases;
but even with this method,
the prediction errors are large.12
The present data should be applicable
to healthy children, including
those with statures or maturational
levels unusual for their
chronological ages.
In making decisions regarding
the cessation of growth-promotingtherapy,
clinicians may utilize the
distributions of age at which
growth in stature ceases. 1 This
approach is limited in value, how-