ESPE Abstracts (2019) 92 P1-360

Prevalence of Children Born Small for Gestational Age with Short Stature who Qualify for Growth Hormone Treatment: A Preliminary Population-Based Study

Gianluca Tamaro1, Mariagrazia Pizzul2, Giuliana Gaeta2, Raffaella Servello2, Marina Trevisan2, Paola Manera Ada Materassi2, Anna Macaluso2, Denis Valentini1, Maria Chiara Pellegrin3, Gianluca Tornese3


1University of Trieste, Trieste, Italy. 2Primary care pediatrician, Trieste, Italy. 3Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy


Background: In 2003 recombinant human growth hormone (rhGH) was approved by European Medicines Agency to treat short children born small for gestational age (SGA), but so far no study evaluated the prevalence of SGA children with short stature who qualify for rhGH treatment in Europe.

Objectives: To investigate the prevalence of SGA and short stature in children born SGA and of SGA children who qualify for rhGH treatment at 4 years of age in an Italian population.

Methods: A preliminary population-based study on 6 (out of 20) primary care pediatricians' databases was conducted in Trieste, Italy. We collected data on 3,595 children who were born between 2004 and 2014 (over 20,120) and who had 4 years of follow-up. Birth weight (BW) or birth length (BL) SDS for sex, gestational age (GA) and birth order (BO) were calculated according to Bertino Italian charts through web-based calculator (www.inescharts.it) and SGA was defined as BW and/or BL≤- 2 SDS. Data on height and weight were collected at the closest visit to 1, 2, 3 and 4 years of age and SDS were calculated by Growth Calculator version 3 (www.weboriented.it/ghc3/). Short stature was defined as height ≤- 2 SDS according to WHO charts for children <5 years. In Italy, short children born SGA can start rhGH treatment when fulfilling all the following criteria: BW or BL ≤-2 SDS for sex and GA according to Bertino charts, age ≥4 years, height ≤-2.5 SDS, growth velocity <50° percentile.

Results: Full data at birth were available for 3,136 children. The prevalence of SGA was 3.6%: 0.8% SGA for weight; 2.2% SGA for length, 0.6% for both weight and length. The prevalence of short stature among SGA children was 9% at 1 year, 6% at 2 years, 4% at 3 years and 3% at 4 years of age. Only 1 child born SGA was eligible for GH treatment: she was not referred to endocrinologist.

Conclusions: Although the prevalence of SGA in our population is similar to previous studies, data on catch-up growth are different from previous reports by Karlberg. Moreover 40% of short children at the age of 2 years in our cohort improved their height later. The prevalence of children born SGA who qualify for GH treatment was 1:3,136, much smaller than the prevalence of 1:1,800 reported by Fujita in the only similar study conducted in Japan (with evaluation at 3 years).