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Growth hormone treatment in cerebral palsy: long-term impact on growth, outcomes, and complications

Pediatric Research (2025)Cite this article

Abstract

Background

This study examined the effects of growth hormone (GH) treatment on growth and metabolic parameters, gross motor function, and musculoskeletal complications in children with cerebral palsy.

Methods

This retrospective single-center study included children who received GH treatment for over 1 year. Data on growth-related variables, metabolic indicators, and disease-specific factors were collected. Statistical analyses examined associations between GH treatment duration and outcomes, with pre- and post-treatment comparisons.

Results

Twenty-two patients were enrolled in this study. GH treatment significantly improved height and weight Z-scores, along with insulin-like growth factor-1 Z-scores, regardless of GH deficiency or ambulatory status. Metabolic changes significantly included an increased bone age-to-chronological age ratio, decreased aspartate aminotransferase levels, and elevated uric acid levels. The gross motor function did not decline, and there was no significant worsening of hip subluxation or scoliosis.

Conclusion

GH treatment led to significant improvements in growth and metabolic-related parameters without adverse effects on gross motor function or musculoskeletal complications. These findings suggest that GH treatment may be a safe and effective treatment option for children with cerebral palsy, providing potential benefits without increasing the risk of orthopedic complications.

Impact

  • This study is the first to assess the long-term effects of GH treatment in children with CP.

  • GH treatment improved height, weight, and insulin-like growth factor-1 Z-scores.

  • Gross motor function did not decline during treatment, and no significant worsening of hip subluxation or scoliosis detected.

  • There is a lack of longitudinal studies on the long-term effects of growth hormone administration in children with CP.

  • It is anticipated that this study will lay the groundwork for large-scale multicenter prospective research.

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Fig. 1: Schematic diagram showing the process of participant selection and data analysis.
Fig. 2: Differences in the outcomes during the GH treatment.
Fig. 3: Comparison of GMFM-66 percentiles by age before and after GH replacement.
Fig. 4: Comparison of migration percentages of hip joints before and after GH replacement.
Fig. 5: Comparison of Cobb angles of spine before and after GH replacement.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank Editage (www.editage.co.kr) for English language editing.

Funding

This study is supported by a 2024 research grant from the Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine. The funding source had no role in the study design; in the collection, analysis, and interpretation of the data; in the writing of the report; and in the decision to submit the paper for publication. The authors declare no interests that might be perceived as posing a conflict or bias.

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Author notes

  1. These authors contributed equally: Juntaek Hong, Sujin Kim.

Authors and Affiliations

  1. Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea

    Juntaek Hong & Dong-wook Rha

  2. Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea

    Sujin Kim & Junghwan Suh

Authors
  1. Juntaek Hong
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  2. Sujin Kim
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  3. Junghwan Suh
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  4. Dong-wook Rha
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Contributions

H.J.T: Conceptualization, Methodology, Visualization, Writing – original draft preparation, Software. K.S: Data curation, Methodology, Writing – original draft preparation. S.J.H: Investigation, Validation, Writing – reviewing & editing. D.W.R: Investigation, Validation, Writing – reviewing & editing. All authors reviewed and approved the final version of the manuscript.

Corresponding authors

Correspondence to Junghwan Suh or Dong-wook Rha.

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Competing interests

The authors declare no competing interests.

Consent statement

The institutional review board of Yonsei University College of Medicine waived the requirement for informed consent, given the practical impossibility of obtaining informed consent from participants during the research process and the minimal risk posed to participants.

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Hong, J., Kim, S., Suh, J. et al. Growth hormone treatment in cerebral palsy: long-term impact on growth, outcomes, and complications. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04440-z

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