Objective: We hypothesized that modelling catch-up growth (CUG) as developed for coeliac disease (CD), might also fit CUG in adequately treated children with juvenile hypothyroidism (JHT) or growth... Show moreObjective: We hypothesized that modelling catch-up growth (CUG) as developed for coeliac disease (CD), might also fit CUG in adequately treated children with juvenile hypothyroidism (JHT) or growth hormone deficiency (GHD).Methods: We used a monomolecular function for all available prepubertal data on height standard deviation score (HSDS) minus target height SDS (adjHSDS) in children with JHT (n=20) and GHD (n=18) on a conventional (CoD) or high GH dose (HD), based either on a national height reference with an age cut-off of 10 (girls) and 12 (boys) years (model 1) or prepubertal height reference values, if age (0) was >= 3, with no upper age limit (model 2).Results: The models could be fitted in 83-90% of cases; in other cases the HSDS decreased after several measurements, which violated the assumption of an irreversible growth process. In JHT, the rate constant (k) and adjHSDS (0) were lower than in CD (p=0.02), but adjHSDS (end) was similar. In GHD (model 1), k was lower than for CD (p=0.004) but similar to JHT, while adjHSDS (0) and adjHSDS (end) were similar to CD and JHT. Thus, the shape of CUG is similar for children with JHT and GHD, while children with CD had less growth deficit at start and a faster CUG. The differences in CUG parameters between GH dose subgroups did not reach statistical significance.Conclusion: Modelling CUG of prepubertal children with JHT and GHD can be used for assessing the adequacy of CUG and the influence of clinical treatment modalities on its speed and magnitude. Show less
Dommelen, P. van; Zoonen, R. van; Vlasblom, E.; Wit, J.M.; Beltman, M.; Expert Comm 2020
Aim To develop a guideline for preventive child healthcare professionals in order to improve early detection of pathological disorders associated with short stature (or growth faltering) or tall... Show moreAim To develop a guideline for preventive child healthcare professionals in order to improve early detection of pathological disorders associated with short stature (or growth faltering) or tall stature (or accelerated growth).Methods We updated the previous Dutch guideline for short stature in children aged 0-9 years and extended it to adolescents (10-17 years), and added a guideline for tall stature, based on literature and input from an expert committee. Specificities were calculated in a cohort of healthy Dutch children aged 0-9 years (n = 970). We investigated the impact of a late onset of puberty on height standard deviation score based on the Dutch growth charts.Results Growth parameters of the guideline include height, the distance between height and target height and change of height over time. Other parameters include diagnostic clues from medical history and physical examination, for example behavioural problems, precocious or delayed puberty, body disproportion and dysmorphic features.Conclusion Preventive child healthcare professionals now have an updated guideline for referring short or tall children to specialist care. Further research is needed on the diagnostic yield after referral and specificity at field level. Show less
Dommelen, P. van; Dijk, O. van; Wilde, J.A. de; Verkerk, P.H. 2020
Aim To investigate the differences in attainment of developmental milestones between young males with Duchenne muscular dystrophy (DMD) and young males from the general population. Method As part... Show moreAim To investigate the differences in attainment of developmental milestones between young males with Duchenne muscular dystrophy (DMD) and young males from the general population. Method As part of the case-control 4D-DMD study (Detection by Developmental Delay in Dutch boys with Duchenne Muscular Dystrophy), data on developmental milestones for 76 young males with DMD and 12 414 young males from a control group were extracted from the health care records of youth health care services. The characteristics of DMD were acquired from questionnaires completed by parents. Logistic regression analyses were performed with milestone attainment (yes/no) as the dependent variable and DMD (yes/no) as the independent variable, with and without adjustment for age at visit. Results The mean number of available milestones was 43 (standard deviation [SD]=13, range: 1-59) in the DMD group and 40 (SD=15, range: 1-60) in the control group. The presence of developmental delay was evident at 2 to 3 months of age, with a higher proportion of young males with DMD failing to attain milestones of gross/fine motor activity, adaptive behaviour, personal/social behaviour, and communication (range age-adjusted odds ratios [ORs]=2.3-4.0,p<0.01). Between 12 and 36 months of age, differences in the attainment of developmental milestones concerning gross motor activity increased with age (range age-adjusted ORs=10.3-532,p<0.001). We also found differences in developmental milestones concerning fine motor activity, adaptive behaviour, personal/social behaviour, and communication between 12 and 48 months of age (range age-adjusted ORs=2.5-9.7,p<0.01). Interpretation We found delays in the attainment of motor and non-motor milestones in young males with DMD compared to the control group. Such delays were already evident a few months after birth. Developmental milestones that show a delay in attainment have the potential to aid the earlier diagnosis of DMD. Show less
Pannebakker, N.M.; Kooken, P.L.; Dommelen, P. van; Mourik, K. van; Reis, R.; Reijneveld, S.A.; Numans, M.E. 2020
BackgroundThere is little evidence on the child and family factors that affect the intensity of care use bychildren with complex problems. We therefore wished to identify changes in these... Show moreBackgroundThere is little evidence on the child and family factors that affect the intensity of care use bychildren with complex problems. We therefore wished to identify changes in these factorsassociated with changes in care service use and its intensity, for care use in general andpsychosocial care in particular.MethodsParents of 272 children with problems in several life domains completed questionnaires atbaseline (response 69.1%) and after 12 months. Negative binominal Hurdle analysesenabled us to distinguish between using care services (yes/ no) and its intensity, i.e. numberof contacts when using care.ResultsChange in care use was more likely if the burden of adverse life events (ALE) decreased(odds ratio, OR = 0.94, 95% confidence interval, CI = 0.90–0.99) and if parenting concernsincreased (OR = 1.29, CI = 1.11–1.51). Psychosocial care use became more likely forschool-age children (vs. pre-school) (OR = 1.99, CI = 1.09–3.63) if ALE decreased (OR =0.93, CI = 0.89–0.97) and if parenting concerns increased (OR = 1.26, CI = 1.10–1.45).Intensity of use (>0 contacts) of any care decreased when ALE decreased (relative risk, RR= 0.95, CI = 0.92–0.98) and when psychosocial problems became less severe (RR = 0.38,CI = 0.20–0.73). Intensity of psychosocial care also decreased when severe psychosocialproblems became less severe (RR = 0.39, CI = 0.18–0.84).ConclusionsChanges in care-service use (vs. no use) and its intensity (>0 contacts) are explained bybackground characteristics and changes in a child’s problems. Care use is related to factors other than changes in its intensity, indicating that care use and its intensity have differentdrivers. ALE in particular contribute to intensity of any care use. Show less
Background Mid-upper arm circumference (MUAC) is suggested as being a valid measure in detecting overweight/obesity in children and adolescents, due to the strong relation with weight. We examined... Show moreBackground Mid-upper arm circumference (MUAC) is suggested as being a valid measure in detecting overweight/obesity in children and adolescents, due to the strong relation with weight. We examined this relation and compared MUAC to body mass index (BMI) according to the International Obesity Task Force (IOTF) in children.Methods Anthropometric data including MUAC were collected in 2009 by trained healthcare professionals in the context of the fifth Dutch Nationwide Growth Study, in a sample of 6167 children (2891 boys and 3276 girls) aged 2-18 years of Dutch origin. We propose MUAC SDS cut-off values for overweight and obesity, and compared MUAC with BMI IOTF in sex-specific and age-specific categories (2-5, 6-11, 12-18 years).Results The area under the curve is used as a measure of diagnostic accuracy; the explained variance (R-2) is good to excellent (0.88-0.94). Sensitivity ranges from 51.8% to 95.3% and specificity from 71.4% to 93.8%. Across age and gender groups, 65.1% to 89.0% participants are classified by both MUAC and BMI as normal weight, overweight or obese. We constructed three equations to predict weight using MUAC, with small differences between observed and predicted weight with an explained variance ranging from 0.88 to 0.94.Conclusions Compared with BMI, MUAC is a valid measure for detecting overweight and obesity and thus a good alternative for BMI. When weight has to be estimated, it can be accurately predicted using MUAC. Based on our observations, we recommend developing diagrams with international (IOTF) cut-offs for MUAC SDS similar to BMI. Show less
Background Delayed language development without an obvious cause is considered an isolated developmental disorder and is called specific language impairment (SLI). SLI is probably the most... Show moreBackground Delayed language development without an obvious cause is considered an isolated developmental disorder and is called specific language impairment (SLI). SLI is probably the most prevalent developmental disorder in childhood with a generally cited prevalence of 7 %. This study aimed to investigate whether SLI is always an isolated disorder or if children with SLI also have delayed motor development. Methods We used data of an earlier study with a prospective nested case-control design in which developmental data were collected from child healthcare files. Cases were children (4-11 years) with diagnosed SLI. They were matched by sex and date of birth with control children attending mainstream education. Data of both groups on seven gross and six fine motor milestones which had been registered in the Dutch Developmental Instrument between the ages of 15- 36 months were retrieved from child healthcare files. McNemar tests were performed to test for differences in reaching motor milestones at the age norm between the case and control group. Results Data from 253 children in each group were available. A significant difference was found between both groups in the proportion failing to reach three of the seven investigated gross motor milestones at the age norm (p < 0.05). The proportion of children not reaching the motor milestone at the age norm was significantly higher for five of the six fine motor milestones in children with SLI compared with control children (p < 0.05). Conclusions More children with SLI are late in reaching motor milestones than children without SLI. This means that it is debatable whether SLI can be regarded as a "specific" impairment which is not associated with other developmental problems. A broader developmental assessment is therefore indicated when diagnosing SLI. Show less
Hermus, M.A.A.; Hitzert, M.; Boesveld, I.C.; Akker-van Marle, M.E. van den; Dommelen, P. van; Franx, A.; ... ; Pal-de Bruin, K.M. van der 2017
OBJECTIVE Prevalence of overweight in children is increasing, causing various health problems. This study aims to establish growth references for weight and to assess the prevalence rates of... Show moreOBJECTIVE Prevalence of overweight in children is increasing, causing various health problems. This study aims to establish growth references for weight and to assess the prevalence rates of overweight and obesity in a nationwide sample of Dutch children with Down syndrome (DS), taking into account the influence of comorbidity. METHODS In 2009, longitudinal growth data from Dutch children with trisomy 21 who were born after 1982 were retrospectively collected from medical records of 25 Dutch regional specialized DS centers. "Healthy" was defined as not having concomitant disorders or having only a mild congenital heart defect. Weight and BMI references were calculated by using the LMS method, and prevalence rates of overweight and obesity by using cutoff values for BMI as defined by the International Obesity Task Force. Differences in prevalence rates were tested by multilevel logistic regression analyses to adjust for gender and age. RESULTS Growth data of 1596 children with DS were analyzed. Compared with the general Dutch population, healthy children with DS were more often overweight (25.5% vs 13.3% in boys, and 32.0% vs 14.9% in girls) and obese (4.2% vs 1.8%, and 5.1% vs 2.2%, respectively). Prevalence rates of overweight between DS children with or without concomitant disorders did not vary significantly. CONCLUSIONS Dutch children with DS have alarmingly high prevalence rates of overweight and obesity during childhood and adolescence. Health care professionals should be aware of the risk of overweight and obesity in children with DS to prevent complications. Show less
Pereira, R.R.; Kanhai, H.; Rosendaal, F.; Dommelen, P. van; Swaab, D.; Pereira, E.R.; Wetering, B. van de 2012
Background:Records show that mean height in The Netherlands has increased since 1858. This study looks at whether this trend in the world's tallest nation is continuing, and we consider the... Show moreBackground:Records show that mean height in The Netherlands has increased since 1858. This study looks at whether this trend in the world's tallest nation is continuing, and we consider the influence of the geographical region, and of child and parental education, on changes in height.Methods:We compared the height of young Dutch people aged 0-21 years as determined on the basis of the growth study of 2009 with the height data from growth studies conducted in 1955, 1965, 1980, and 1997.Results:The analysis sample included 5,811 boys and 6,194 girls. Height by age was the same as in 1997. Mean final height was 183.8 cm (SD=7.1 cm) in boys and 170.7 cm (SD=6.3 cm) in girls. The educational levels of both children and their parents are positively correlated with mean height. Since 1997, differences between geographical regions have decreased but not vanished, with the northern population being the tallest.Conclusion:The world's tallest population has stopped growing taller after a period of 150 years. The cause is unclear. The Dutch may have reached the optimal height distribution. Alternatively, growth-promoting environmental factors may have stabilised in the last decade, preventing the population from attaining its full growth potential.Pediatric Research (2012); doi:10.1038/pr.2012.189. Show less
Verheijden, M.W.; Dommelen, P. van; Empelen, P. van; Crone, M.R.; Werkman, A.M.; Kesteren, N.M.C. van 2012
BACKGROUND Prevention of (serious) overweight can be achieved by means of small behaviour changes in physical activity and/or diet. OBJECTIVE To evaluate a mass media campaign promoting energy... Show moreBACKGROUND Prevention of (serious) overweight can be achieved by means of small behaviour changes in physical activity and/or diet. OBJECTIVE To evaluate a mass media campaign promoting energy balance behaviours in a Dutch population. Effects were examined for body mass index (BMI) and five energy balance behaviours. METHODS A representative cohort study of 1200 Dutch adults was employed. Data were collected at four moments. Two campaign waves were launched, following T1 (targeting the general adult population) and T2 [targeting low socio-economic status (SES) men], respectively. Regression analyses were performed to estimate the short-term and long-term effects of campaign exposure. RESULTS In total, data of 1030 participants (86%) were available. Time trends showed unfavourable changes in most but not all energy balances behaviour for the total sample. No differences were found for BMI. No differences in the outcome measures were found as a result of exposure to the first campaign (19%). A short-term effect of exposure to the second campaign (29% exposure) was found (T2-T3), but only for low SES respondents, with increases in the attention being paid towards food choice (P = 0.02). At long term, BMI was less likely to increase among exposed people with a non-Dutch ethnicity (P = 0.01, T2-T4). CONCLUSIONS Exposure to the campaign was low. The first campaign wave had no effects on BMI and energy balance behaviours. Small but favourable changes in attention towards food choice and BMI for at-risk populations were observed among those exposed to the second campaign wave. Show less
Gameren-Oosterom, H.B.M. van; Dommelen, P. van; Oudesluys-Murphy, A.M.; Buitendijk, S.E.; Buuren, S. van; Wouwe, J.P. van 2012
