Repercussions on growth and development depend on the intensity and duration of action of these factors. Thus, if these factors operate during periods of rapid growth (the first week, first month, the first years of life, puberty) the repercussions on growth and development will be more severe.
1. Among the external environmental factors (exogenous) which put their mark on child development, most significant are:
– The geographical environment;
– socio-economic factors;
– Affective and educative factors;
– Chemical emissions, radiation, trauma;
– Cultural factors.
Diet is very important because is acting since the womb. Thus, maternal malnutrition will pass on the nutritional status of children (children will have a lower weight and length at birth) and the development of the child’s upper nerves (nerve cell multiplication occurs both in utero and in the first 6 months postnatal).
Deficiency of food principles, such as protein and minerals will lead to enzyme and hormonal disorders, coagulation disorders, impaired skeletal mineralization.
Overeating can lead to obesity.
Geographical environment in terms of microclimate (air, sun, light, temperature, atmospheric pressure) acts mainly in the first 5 years of life.
Socio-economic factors which put the mark on growth and development are: sanitary conditions, various parasitic morbidities, housing, stress, financial situation.
Affective and educational factors – This includes family climate. Thus in a family dominated by calm and optimism, which will encourage the child’s actions, the child will develop better than others who grow up in dysfunctional families or where there is conflict states.
Exercises like massage, gymnastics for infant and subsequently other age appropriate exercises have a positive role on the growth and development.
Pollutants, radiation or trauma have a negative impact on the stature and weight development.
2. Among internal environmental factors (endogenous) that influence growth and development, an extremely important role is due to genetic factors and hormonal factors.
Genetic factors put the mark both on the weight development and intellectual development.
Hormonal factors are particularly important in the stature-weight and intellectual development.
The most important hormones involved in these processes are the hormones secreted by pituitary (somatotrope), thyroid (tiroxina. triiodothyronine), pancreas (insulin, glucagon), thymus, adrenal glands (glucocorticoids), parathyroid gland and the sex glands ( androgen).
Disturbances in the synthesis and release of these hormones will pass in a negative way on child development.
Thus, secretion failure of somatotrope hormone (GH) at pituitary level will have as clinical repercussions dwarfism occurrence (harmonic dwarf, balanced without intellectual impairment). An excess secretion of somatotrope (GH) is the basis for another condition named gigantism (characterized by excessive growth, but harmonic length).
Disturbances in thyroid hormone secretion in the sense of failure can lead to myxedema, a condition characterized by abnormal growth (disharmonic dwarf), sexual and intellectual development deficit.
In addition to exogenous and endogenous factors, growth and development can be interfered negatively by pathological factors (chronic diseases as cystic fibrosis, chronic renal insufficiency, malabsorption).
Bibliography: 1. Braunwald's Heart Disease; 2. Harrison's Principles of Internal Medicine; 3. European Society of Cardiology - Clinical Practice Guidelines.