Einfluss von psychosozialen Belastungsfaktoren auf das Längenwachstum

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

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