Objective: To evaluate the validity of self-assessment of sexual maturity status (SMS) in children with Crohn's disease (CD), a pediatric chronic disease that often affects growth and development.
Study design: Self-assessment of SMS in 100 children (34 girls) ages 8 to 18 years with CD from the Children's Hospital of Philadelphia was compared with an independent assessment by one well trained pediatrician, using drawings and written descriptions of Tanner stages of breast, genital, and pubic hair development.
Results: Overall, subjects with CD (age, 14.3 +/- 2.8 years) had delayed growth status based on height-for-age (HAZ) and weight-for-age Z scores (WAZ). Boys were more growth delayed (HAZ, -0.90 +/- 1.1; WAZ, -0.75 +/- 1.3) than girls (HAZ, -0.45 +/- 1.3; WAZ, -0.20 +/- 1.1). Kappa coefficients (kappa) showed excellent agreement between child and physician assessment of SMS, ranging from kappa = 0.74 to 0.85, depending on sex and SMS component, corresponding to a 79% to 88% agreement. When not in agreement, children tended to overestimate their SMS. Boys who overestimated (n = 8) had significantly higher weight and BMI status than boys who assessed accurately.
Conclusions: Self-assessment of SMS was a reliable and valid method in children with CD and is useful in screening for maturational delay in children with chronic disease.