EVALUATION OF A DISTRICT GROWTH SCREENING-PROGRAM - THE OXFORD GROWTH STUDY

The Oxford district growth screening programme was established in 1988 as a community based survey of the heights of children at 3 and 4.5 years of age in a district of 550 000 people. The current birthrate is 7500 births/year and over the first three years of the study 20 338 children were screened in the community; the ascertainment ranged from 61-73.9% of the total expected. Mean height SD scores were significantly greater than the British standards: mean SD scores for boys and girls were 0.33 and 0-35 respectively at age 3, and 0.20 and 0.26 at 4.5 years. Altogether 260 (1.3%) of the total cohort were found to have heights less-than-or-equal-to -2SD scores. The mean growth velocity of 2742 children measured at 3 and 4.5 years of age was similar to that of the national standards, 7.14 cm/year in boys and 7.21 cm/year in girls. Follow up data was available from 149 children whose heights were confirmed to be less-than-or-equal-to -2SD scores. Of these 69 were already under the care of paediatricians. Thus far diagnoses in the 149 have included growth hormone deficiency (n=2), Turner's syndrome (n=2), Noonan's syndrome (n=4), and emotional deprivation (n=1). Ways in which ascertainment and detection of treatable causes of short stature could be improved are discussed and it is concluded that community growth screening is a useful part of the child health surveillance programme.