Growth Deficiency
Growth deficiency is defined as below average height, weight or both due to prenatal alcohol exposure, and can be assessed at any point in the lifespan. Growth measurements must be adjusted for parental height, gestational age (for a premature infant), and other postnatal insults (e.g., poor nutrition), although birth height and weight are the preferred measurements. Deficiencies are documented H191 when height or weight falls at or below the 10th percentile of standardized growth charts appropriate to the patient's population.
The CDC and Canadian guidelines use the 10th percentile as a cut-off to determine growth deficiency. The "4-Digit Diagnostic Code" allows for mid-range gradations in growth deficiency (between the 3rd and 10th percentiles) and severe growth deficiency at or below the 3rd percentile. Growth deficiency (at severe, moderate, or mild levels) contributes to diagnoses of FAS and PFAS (Partial Fetal Alcohol Syndrome), but not ARND (Alcohol-Related Neurodevelopmental Disorder) or static encephalopathy.
Growth deficiency is ranked as follows by the "4-Digit Diagnostic Code:"
Severe — Height and weight at or below the 3rd percentile.
Moderate — Either height or weight at or below the 3rd percentile, but not both.
Mild — Both height and weight between the 3rd and 10th percentiles.
None — Height and weight both above the 10th percentile.