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Chapter-02 Growth and Development

BOOK TITLE: Hutchison's Paediatrics

Author
1. Low Louis
ISBN
9788184485868
DOI
10.5005/jp/books/10367_2
Edition
1/e
Publishing Year
2009
Pages
9
Author Affiliations
1. The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
Chapter keywords

Abstract

Apart from nutrition, hormones and growth factors have an important role in the control of foetal growth. Foetal insulin secretion is dependent on the placental nutrition supply and foetal hyperinsulinaemia stimulates cell proliferation and foetal fat accumulation from 28 weeks gestation onwards. Thyroid hormone, which affects cell differentiation and brain development, is also regulated by nutrition. Cortisol is essential for the prepartum maturation of different organs including the liver, lung, gut and pituitary gland. Although growth hormone (GH) is important in postnatal growth, it plays an insignificant role in foetal growth except for an effect on foetal fat content. Animal knockout studies and human observations have shown that IGFs are most important for metabolic, mitogenic and differentiative activities of the foetus. IGF-II is more important in early embryogenesis. In humans, foetal body weight is more closely correlated with the concentration of foetal serum IGF-1 than IGF-II. The prevalence of wasting in preschool children in Cambodia, Indonesia, Indian subcontinent, some island states in the Indian Ocean and some countries in Africa and Middle East has remained above 10%. According to WHO, 110 million stunted children live in Asia in 2005. In recent years, there is increasing demand for paediatricians to develop skills in dealing with children with behavioural and emotional disorders. Measurements of behavioural and emotional well-being and adjustment in children and their family members can be achieved using the Child Behaviour Check List (CBCL) for parents, teachers and older children. Paediatricians should be aware of common presentations of such disorders and have some knowledge of neuropsychological test instruments for the assessment of childhood depression, anxiety, obsessive-compulsive, attention deficit hyper activity disorders, eating disorders and conduct disorders. These conditions will be discussed in greater details under the different chapters of this book.

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