Download PDF
Klin Padiatr 2022; 234(02): 61-67
DOI: 10.1055/a-1672-4759
Übersicht

Einfluss von psychosozialen Belastungsfaktoren auf das Längenwachstum

Effect of Psychosocial Factors on Growth
Bettina C. Gohlke
1   Pädiatrische Endokrinologie, Universitätskinderklinik, Endokrinologie Bonn, Germany, Bonn, Deutschland
,
Markus Bettendorf
2   Division of Paediatric Endocrinology and Diabetes, University Childrenʼs Hospital Heidelberg, University Hospital Heidelberg, Heidelberg, Deutschland
,
Gerhard Binder
3   Paediatric Endocrinology, University Hospital Tubingen Department of Pediatrics, Tubingen, Deutschland
,
Berthold Hauffa
4   Universitätsklinikum Essen, Klinik für Pädiatrische Hämatologie, Onkologie und Endokrinologie, Essen, Deutschland
,
Thomas Reinehr
5   Pädiatrische Ernährungsmedizin, Vestische Kinderklinik, Datteln, Deutschland
,
Helmuth-Guenther Dörr
6   Department of Pediatrics, University of Erlangen-Nürnberg, Erlangen, Deutschland
,
Joachim Wölfle
7   Department of Paediatrics, Erlangen University Hospital, Erlangen, Deutschland
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Zusammenfassung

Hintergrund Wachstum wird durch Hormone, genetische und exogene Faktoren beeinflusst.

Fragestellungen Welche Bedeutung haben Psyche, Lebensumstände oder maternaler Drogenkonsum in der Schwangerschaft für das Wachstum von Kindern?

Methoden Ergebnisse eines Arbeitstreffens pädiatrischer Endokrinologen mit aktueller Literaturrecherche.

Ergebnisse Psychosoziale Deprivation kann bei Kindern mit Kleinwuchs und einem Wachstums-hormon (WH)-Mangel einhergehen, der bei Änderung der Umgebung und unter psychosozialer Unterstützung reversibel ist. Krieg und Migration gehen häufig mit Untergewicht, Wachstumsstörung und schlechter Gesundheitsversorgung einher. Diese bessern sich nach Konfliktende, die Kinder bleiben dennoch häufig zu klein. Alkohol- oder Drogenkonsum von Schwangeren sind mit einem niedrigeren Geburtsgewicht und einem erhöhten Risiko für Früh- und „small for gestational age“ (SGA)-Geburtlichkeit assoziiert. Kinder mit Aufmerksamkeitsdefizit-Hyperaktivitäts-Syndrom (ADHS) zeigten meist nach Beginn einer Stimulanzientherapie eine leichte Wachstumsverlangsamung, erreichen aber eine normale Endhöhe.

Schlussfolgerungen Bei Kindern mit idiopathischem Kleinwuchs sollte differenzialdiagnostisch die psychosoziale Genese in Betracht gezogen werden. Eine Stimulanzientherapie bei ADHS wirkt sich demgegenüber auf das Wachstum kaum aus.

Abstract

Background Genes, hormones and factors such as nutrition and psychosocial environment affect growth.

Objective What is the significance of various psychosocial factors on growth?

Methods Evaluation of results of a working meeting of paediatric endocrinologist with current literature research.

Results Psychosocial deprivation in children can be associated with growth hormone deficiency (GHD) and short stature. GHD can be reversed by a change of environment and psychosocial support. War and migration are often associated with underweight, growth disturbances and poor health care. These factors can improve after the end of conflicts, but children often remain too short. Consumption of alcohol or opiates during pregnancy are associated with lower birth weight and increased risk of early and small for gestational age (SGA) childbirth. Children with attention deficit hyperactivity disorder show a slight slowdown in growth after they started stimulant therapy. However, they reach normal adult height.

Conclusions In children with idiopathic short stature, psychosocial causes should be taken into account in the differential diagnosis. Notably there is an increased risk of growth disturbances in children from conflict regions or after prenatal drug exposure.

Schlüsselwörter

psychosoziale Deprivation - Migration - Drogenkonsum - ADHS - Wachstum

Key words

Growth - psychosocial deprivation - migration maternal drug abuse - ADHDonline publiziert 2021


Publication History

Article published online:
13 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Alasagheirin MH, Clark MK. Skeletal growth, body composition, and metabolic risk among North Sudanese immigrant children. Public health nursing (Boston, Mass) 2018; 35: 91-99
    CrossrefPubMedSearch in Google Scholar
  • 2 Bereket A. et al. Height, weight, IGF-I, IGFBP-3 and thyroid functions in prepubertal children with attention deficit hyperactivity disorder: effect of methylphenidate treatment. Horm Res 2005; 63: 159-164
    CrossrefPubMedSearch in Google Scholar
  • 3 Biederman J. et al. A naturalistic 10-year prospective study of height and weight in children with attention-deficit hyperactivity disorder grown up: sex and treatment effects. J Pediatr 2010; 157: 635-640, 640.e631
    CrossrefPubMedSearch in Google Scholar
  • 4 Blizzard RM, Bulatovic A. Psychosocial short stature: a syndrome with many variables. Bailliere’s clinical endocrinology and metabolism 1992; 6: 687-712
    CrossrefPubMedSearch in Google Scholar
  • 5 Boerma T. et al. Armed conflicts and national trends in reproductive, maternal, newborn and child health in sub-Saharan Africa: what can national health surveys tell us?. BMJ Glob Health 2019; 4: e001300
    CrossrefPubMedSearch in Google Scholar
  • 6 Bogin B. et al. As tall as my peers – similarity in body height between migrants and hosts. Anthropol Anz 2018; 74: 365-376
    CrossrefPubMedSearch in Google Scholar
  • 7 Burns L. et al. The use of record linkage to examine illicit drug use in pregnancy. Addiction 2006; 101: 873-882
    CrossrefPubMedSearch in Google Scholar
  • 8 Carter RC. et al. Fetal Alcohol Growth Restriction and Cognitive Impairment. Pediatrics 2016; 138
    CrossrefPubMedSearch in Google Scholar
  • 9 Committee on Obstetric, P Committee Opinion No. 722: Marijuana Use During Pregnancy and Lactation. Obstet Gynecol 2017; 130: e205-e209
    CrossrefPubMedSearch in Google Scholar
  • 10 Day NL. et al. Prenatal alcohol exposure predicts continued deficits in offspring size at 14 years of age. Alcoholism, clinical and experimental research 2002; 26: 1584-1591
    CrossrefPubMedSearch in Google Scholar
  • 11 Day NL. et al. Alcohol, marijuana, and tobacco: effects of prenatal exposure on offspring growth and morphology at age six. Alcoholism, clinical and experimental research 1994; 18: 786-794
    CrossrefPubMedSearch in Google Scholar
  • 12 Demirci H. et al. Birth characteristics of Syrian refugees and Turkish citizens in Turkey in 2015. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2017; 137: 63-66
    CrossrefPubMedSearch in Google Scholar
  • 13 Faraone SV. et al. Effect of stimulants on height and weight: a review of the literature. Journal of the American Academy of Child and Adolescent Psychiatry 2008; 47: 994-1009
    CrossrefPubMedSearch in Google Scholar
  • 14 Fredriks AM. et al. Height, weight, body mass index and pubertal development references for children of Moroccan origin in The Netherlands. Acta Paediatr 2004; 93: 817-824
    CrossrefPubMedSearch in Google Scholar
  • 15 Frindik JP. et al. Stimulant medication use and response to growth hormone therapy: an NCGS database analysis. Horm Res 2009; 72: 160-166
    CrossrefPubMedSearch in Google Scholar
  • 16 Gilmour J. et al. Hyperphagic short stature and Prader – Willi syndrome: a comparison of behavioural phenotypes, genotypes and indices of stress. Br J Psychiatry 2001; 179: 129-137
    CrossrefPubMedSearch in Google Scholar
  • 17 Grammatikopoulou MG. et al. Malnutrition surveillance among refugee children living in reception centres in Greece: a pilot study. International health 2019; 11: 30-35
    CrossrefPubMedSearch in Google Scholar
  • 18 Grant KS. et al. Cannabis use during pregnancy: Pharmacokinetics and effects on child development. Pharmacol Ther 2018; 182: 133-151
    CrossrefPubMedSearch in Google Scholar
  • 19 Gualdi-Russo E. et al. Health, growth and psychosocial adaptation of immigrant children. European journal of public health 2014; 24: 16-25
    CrossrefPubMedSearch in Google Scholar
  • 20 Gunn JK. et al. Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis. BMJ open 2016; 6: e009986
    CrossrefPubMedSearch in Google Scholar
  • 21 Harstad EB. et al. ADHD, stimulant treatment, and growth: a longitudinal study. Pediatrics 2014; 134: e935-e944
    CrossrefPubMedSearch in Google Scholar
  • 22 Hellstrom A. et al. Growth hormone status in six children with fetal alcohol syndrome. Acta Paediatr 1996; 85: 1456-1462
    CrossrefPubMedSearch in Google Scholar
  • 23 Henderson J. et al. Systematic review of effects of low-moderate prenatal alcohol exposure on pregnancy outcome. BJOG : an international journal of obstetrics and gynaecology 2007; 114: 243-252
    CrossrefPubMedSearch in Google Scholar
  • 24 Hulse GK. et al. The relationship between maternal use of heroin and methadone and infant birth weight. Addiction 1997; 92: 1571-1579
    CrossrefPubMedSearch in Google Scholar
  • 25 Hunt RD. et al. Possible change in noradrenergic receptor sensitivity following methylphenidate treatment: growth hormone and MHPG response to clonidine challenge in children with attention deficit disorder and hyperactivity. Life sciences 1984; 35: 885-897
    CrossrefPubMedSearch in Google Scholar
  • 26 Klein RG. et al. Methylphenidate and growth in hyperactive children. A controlled withdrawal study. Arch Gen Psychiatry 1988; 45: 1127-1130
    CrossrefPubMedSearch in Google Scholar
  • 27 Klein RG, Mannuzza S. Hyperactive boys almost grown up. III. Methylphenidate effects on ultimate height. Arch Gen Psychiatry 1988; 45: 1131-1134
    CrossrefPubMedSearch in Google Scholar
  • 28 Klug MG. et al. Body mass index in fetal alcohol syndrome. Neurotoxicology and Teratology 2003; 25: 689-696
    CrossrefPubMedSearch in Google Scholar
  • 29 Kramer JR. et al. Predictors of adult height and weight in boys treated with methylphenidate for childhood behavior problems. Journal of the American Academy of Child and Adolescent Psychiatry 2000; 39: 517-524
    CrossrefPubMedSearch in Google Scholar
  • 30 Landgraf MN. et al. Diagnosis of fetal alcohol syndrome (FAS): German guideline version 2013. Eur J Paediatr Neurol 2013; 17: 437-446
    CrossrefPubMedSearch in Google Scholar
  • 31 Leemaqz SY. et al. Maternal marijuana use has independent effects on risk for spontaneous preterm birth but not other common late pregnancy complications. Reprod Toxicol 2016; 62: 77-86
    CrossrefPubMedSearch in Google Scholar
  • 32 Lunde ER. et al. Alcohol-Induced Developmental Origins of Adult-Onset Diseases. Alcoholism, clinical and experimental research 2016; 40: 1403-1414
    CrossrefPubMedSearch in Google Scholar
  • 33 Mattes JA, Gittelman R. Growth of hyperactive children on maintenance regimen of methylphenidate. Arch Gen Psychiatry 1983; 40: 317-321
    CrossrefPubMedSearch in Google Scholar
  • 34 McCarthy S. et al. Effects of long-term methylphenidate use on growth and blood pressure: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). BMC psychiatry 2018; 18: 327
    CrossrefPubMedSearch in Google Scholar
  • 35 Mehls O. et al. Is the response to growth hormone in short children born small for gestational age dependent on genetic or maternal factors?. Horm Res 2009; 72: 106-113
    CrossrefPubMedSearch in Google Scholar
  • 36 Metzner F. et al. Psychotherapeutische Versorgung von begleiteten und unbegleiteten minderjährigen Flüchtlingen und Asylbewerbern mit Traumafolgestörungen in Deutschland. Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz 2016; 59: 642-651
    CrossrefPubMedSearch in Google Scholar
  • 37 Miller JD. et al. Daytime pulsatile growth hormone secretion during childhood and adolescence. J Clin Endocrinol Metab 1982; 55: 989-994
    CrossrefPubMedSearch in Google Scholar
  • 38 Olson BG. et al. Rapid Weight Gain in Pediatric Refugees after US Immigration. Journal of immigrant and minority health 2017; 19: 263-266
    CrossrefPubMedSearch in Google Scholar
  • 39 Pak S. The growth status of North Korean refugee children and adolescents from 6 to 19 years of age. Economics and human biology 2010; 8: 385-395
    CrossrefPubMedSearch in Google Scholar
  • 40 Pastrakuljic A. et al. The effects of cocaine and nicotine on amino acid transport across the human placental cotyledon perfused in vitro. J Pharmacol Exp Ther 2000; 294: 141-146
    PubMedSearch in Google Scholar
  • 41 Patra J. et al. Dose-response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age (SGA)-a systematic review and meta-analyses. BJOG : an international journal of obstetrics and gynaecology 2011; 118: 1411-1421
    CrossrefPubMedSearch in Google Scholar
  • 42 Powell GF. et al. Emotional deprivation and growth retardation simulating idiopathic hypopituitarism. I. Clinical evaluation of the syndrome. N Engl J Med 1967; 276: 1271-1278
    CrossrefPubMedSearch in Google Scholar
  • 43 Powell GF. et al. Emotional deprivation and growth retardation simulating idiopathic hypopituitarism. II. Endocrinologic evaluation of the syndrome. N Engl J Med 1967; 276: 1279-1283
    CrossrefPubMedSearch in Google Scholar
  • 44 Rose SR. et al. Attention-Deficit/Hyperactivity Disorder Medication Treatment Impact on Response to Growth Hormone Therapy: Results from the ANSWER Program, a Non-Interventional Study. J Pediatr 2015; 167: 1389-1396
    CrossrefPubMedSearch in Google Scholar
  • 45 Safer DJ, Allen RP. Factors influencing the suppressant effects of two stimulant drugs on the growth of hyperactive children. Pediatrics 1973; 51: 660-667
    CrossrefPubMedSearch in Google Scholar
  • 46 Safer DJ. et al. Growth rebound after termination of stimulant drugs. J Pediatr 1975; 86: 113-116
    CrossrefPubMedSearch in Google Scholar
  • 47 Salehi L. et al. Health and growth status of immigrant and refugee children in Toronto, Ontario: A retrospective chart review. Paediatrics & child health 2015; 20: e38-e42
    CrossrefPubMedSearch in Google Scholar
  • 48 Schlack R. et al. Die Prävalenz der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) bei Kindern und Jugendlichen in Deutschland. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 2007; 50: 827-835
    CrossrefPubMedSearch in Google Scholar
  • 49 Schouler-Ocak M. Psychische Gesundheit von Menschen mit Migrations- und Fluchthintergrund in Deutschland. In: Genkova P, Riecken A, Hrsg. Handbuch Migration und Erfolg: Psychologische und sozialwissenschaftliche Aspekte. Wiesbaden: Springer Fachmedien Wiesbaden; 2020: 567-587
    CrossrefSearch in Google Scholar
  • 50 Schultz FR. et al. Methylphenidate treatment of hyperactive children: effects on the hypothalamic-pituitary-somatomedin axis. Pediatrics 1982; 70: 987-992
    CrossrefPubMedSearch in Google Scholar
  • 51 Serino Ma D. et al. Psychological Functioning of Women Taking Illicit Drugs during Pregnancy and the Growth and Development of Their Offspring in Early Childhood. J Dual Diagn 2018; 14: 158-170
    CrossrefPubMedSearch in Google Scholar
  • 52 Skuse D. et al. A new stress-related syndrome of growth failure and hyperphagia in children, associated with reversibility of growth-hormone insufficiency. Lancet 1996; 348: 353-358 DOI: S014067369601358X [pii]
    CrossrefPubMedSearch in Google Scholar
  • 53 Stanhope R. et al. Physiological growth hormone (GH) secretion during the recovery from psychosocial dwarfism: a case report. Clin Endocrinol (Oxf) 1988; 28: 335-339
    CrossrefPubMedSearch in Google Scholar
  • 54 Storebø OJ. et al. Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents - assessment of adverse events in non-randomised studies. Cochrane Database Syst Rev 2018; 5: Cd012069
    CrossrefPubMedSearch in Google Scholar
  • 55 Swanson JM. et al. Young adult outcomes in the follow-up of the multimodal treatment study of attention-deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression. Journal of child psychology and psychiatry, and allied disciplines 2017; 58: 663-678
    CrossrefPubMedSearch in Google Scholar
  • 56 Swanson JM. et al. Effects of stimulant medication on growth rates across 3 years in the MTA follow-up. Journal of the American Academy of Child and Adolescent Psychiatry 2007; 46: 1015-1027
    CrossrefPubMedSearch in Google Scholar
  • 57 Talbot NB. et al. Dwarfism in healthy children; its possible relation to emotional nutritional and endocrine disturbances. N Engl J Med 1947; 236: 783-793
    CrossrefPubMedSearch in Google Scholar
  • 58 Toren P. et al. Lack of effect of methylphenidate on serum growth hormone (GH), GH-binding protein, and insulin-like growth factor I. Clinical neuropharmacology 1997; 20: 264-269
    CrossrefPubMedSearch in Google Scholar
  • 59 Widdowson EM. Mental contentment and physical growth. Lancet 1951; 1: 1316-1318
    CrossrefPubMedSearch in Google Scholar