Short stature is defined as a height of more than two standard deviations below the average for a child’s age and sex, equivalent to below the 2nd centile on a growth chart.
Predicted Height
A child’s predicted height can be estimated based on their parents’ height, measured in centimetres:
- Boys predicted height = (mother height + fathers height + 13) / 2
- Girls predicted height = (mothers height + father height – 13) / 2
Causes
- Familial short stature
- Constitutional delay in growth and puberty (GDGP)
- Malnutrition
- Chronic diseases (e.g., coeliac disease, inflammatory bowel disease or congenital heart disease)
- Endocrine disorders (e.g., hypothyroidism or growth hormone deficiency)
- Genetic conditions (e.g., Down syndrome or Turner syndrome)
- Skeletal dysplasias (e.g., achondroplasia)
Constitutional Delay In Growth and Puberty
Constitutional delay in growth and puberty (CDGP) is considered a variation on normal development. It leads to short stature in childhood when compared with peers but normal height in adulthood. Puberty is delayed and the growth spurt during puberty lasts longer. They ultimately reach their predicted adult height.
X-ray of the wrist and hand can be used to estimate the age by assessing the size and shape of the bones and the growth plates. Children with CDGP will have a delayed bone age compared with chronological age.
Diagnosis is based on a suggestive history, examination and bone age. Management involves excluding other causes of a short stature and delayed puberty, reassuring parents and the child and monitoring growth over time.
Last updated October 2025
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