Abstract
The aim of this observational study was to assess the long-term growth responses to GH treatment of children born small for gestational age (SGA). GH treatment was begun before puberty and continued to final height (FH). Seventy-seven short (height SD score below −2) prepubertal children born SGA (below −2 SD for birth weight and/or birth length), with a broad range of GH secretory capacity, were treated with GH in a daily dose of 33 μg/kg (0.1 U/kg), beginning before the onset of puberty. We observed a difference between adult and pretreatment projected height of 1.3 SD (9 cm) for the entire group. Among the children treated for >2 y before puberty, this mean gain (i.e. difference) in final height was 1.7 SD, whereas the mean gain was 0.9 SD among those in whom treatment was begun <2 y before puberty. Better catch-up growth was observed in the younger (r = −0.56, p < 0.0001), shorter (r = −0.49, p < 0.0001), and lighter (r = −0.46, p < 0.0001) subjects. We conclude that GH treatment improves the final height of short children born SGA. The height gain attained before the onset of puberty is maintained to final height. The younger, shorter, and lighter the child at the start of GH treatment, the better the response. Moreover, most of these SGA individuals treated with GH reach their target height.
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Abbreviations
- AGA:
-
appropriate for gestational age
- AITT:
-
arginine-insulin tolerance test
- Diff SDS:
-
the intrafamily difference in SDS (i.e. the difference in height SDS of the child compared with his/her MPH SDS)
- FH:
-
final height
- GHD:
-
GH deficient
- MPH:
-
mid-parental height SDS
- SDS:
-
SD score
- SGA:
-
small for gestational age
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Acknowledgements
The authors thank Sten Rosberg and Birgitta Svensson for technical support and Gunnar Ekeroth for statistical support, the personnel of Ward 335, and the Growth Laboratory, Queen Silvia Children's Hospital (Göteborg). We also thank the children and parents who participated. We thank the endocrine units of the university hospitals in Sweden, participating teams in the National Registry for GH Treatment, both doctors and nurses, and especially the participants in the Swedish Study Group for GH Treatment: Kerstin Albertsson Wikland, Stefan Aronson, Jan Gustafsson, Lars Hagenäs, Anders Häger, Sten Ivarsson, Berit Kriström, Karl-Olof Nilsson, Martin Ritzén, Torsten Tuvemo, Ulf Westgren, and Otto Westphal.
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Supported by grants from the Swedish Medical Research Council (no. 7509), the Tore Nilsson Foundation, the Magnus Bergwall Foundation, the University of Göteborg, and an unrestricted grant from Pharmacia/Pfizer.
Participants in the Swedish Study Group for GH treatment: Kerstin Albertsson Wikland, Stefan Aronsson, Jan Gustafsson, Lars Hagenäs, Anders Häger, Sten Ivarsson, Berit Kriström, Karl-Olof Nilsson, Martin Ritzén, Torsten Tuvemo, Ulf Westgren, and Otto Westphal.
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Dahlgren, J., Wikland, K. & THE SWEDISH STUDY GROUP FOR GROWTH HORMONE TREATMENT. Final Height in Short Children Born Small for Gestational Age Treated with Growth Hormone. Pediatr Res 57, 216–222 (2005). https://doi.org/10.1203/01.PDR.0000148716.71231.81
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DOI: https://doi.org/10.1203/01.PDR.0000148716.71231.81
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