“Catching-up” on catch-up growth

propose recommendations for how to manage children with Prader-Willi syndrome with regards to starting growth hormone therapy. Article page 263< Editorial page 224<

“Catching-up” on catch-up growth — Robert W. Wilmott, MD

Underinsurance of children is common and effects their access to care and their health — Sarah S. Long, MD

Scimitar syndrome and the lung — Robert W. Wilmott, MD

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he term “catch-up growth” is used to describe rapid growth in children following a period of reduced growth; it is particularly common in small for gestation as age infants. In this issue of The Journal, the patterns of catch-up growth are discussed in a Commentary by Wit et al from the University of Auckland and Leiden University. They identify three patterns of catch-up growth and recommend that reports on catch-up growth, or phases of the growth curve up to adult height, should be described in the context of parental heights. They also discuss growth patterns in several different clinical disorders. Article page 415< n this issue of The Journal, the questionnaire study by Spears et al included a sample of approximately 2900 parents visiting a pediatrician’s office in Ohio in 2009 and 2010; almost one-half reported annual household income < $35 000 and 61% reported having private health insurance. In this study, children were identified as underinsured if they lived in families who could not afford clinician-recommended healthcare despite having insurance coverage for their children. Approximately 17% of parents who answered the questionnaire gave answers denoting that their children were underinsured. More than one-third of parents of underinsured children believed that their child’s health had suffered because of inability to pay for pediatrician’s recommended care. Children covered by private insurance were 1.9 times more likely to be underinsured than children covered by public insurance in this sample. A large share of medical care costs are paid out of pocket in the US; high deductibles and copays likely lead to unaffordable recommended care for many children, and parents are concerned and stressed that their children’s health has suffered. Data from this study should provide a needed baseline for children in order to monitor the impact of the Patient Protection and Affordable Care Act. Article page 403<

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he respiratory morbidities and lung function tests associated with scimitar syndrome were investigated in a series of 81 children followed by Chemin et al. A high rate of pulmonary infections and wheezing was observed during the last 12 months of follow-up, and one-third of children had been re-hospitalized for respiratory cause. Lung function tests in 20 children showed reductions in total lung capacity and FEV1. Significantly lower total lung capacity values were observed in children with the infantile form of the syndrome or a history of thoracic surgery. These results show that respiratory complications are quite common in children with scimitar syndrome, and it was noted that pulmonary hypoplasia appears to be an independent marker of long-term severity. Article page 275<

Vol. 162, No. 2