Background: Children born small for gestational age (SGA) with poor growth during the first years of life often remain with short stature during childhood and as adults.
Objective and hypotheses: To evaluate the effects of gender and gestational age (GA) on outcomes of GH treatment in very young children born SGA.
Method: 620 short SGA children on GH treatment enrolled in KIGS (The Pfizer International Growth Database) were analysed: 24 years age group (n=156; 100 boys; median age 3.3 years; 50% with GA ≤37 weeks) and 46 years group (n=464; 284 boys; median age 4.9 years; 42.2% with GA ≤37 weeks).
Results: In the 24 years group, girls presented lower height SDS (HSDS) at start of treatment (−4.18 vs −3.80; P<0.01), presented a higher increase in height during the first year (Δ HSDS 1.02 vs 0.87; P<0.05), with consequent disappearance of the difference in height at 3 years of treatment. In the 46 years group, girls were also shorter (HSDS −3.57 vs −3.33; P<0.01), but their height velocity (HV) during the first year of treatment was lower (2.74 vs 3.36 SDS; P<0.01); HSDS was still different at 3 years of therapy (-2.15 vs -1.93 SDS; P<0.05). Preterm children in the 46 years group were younger than the term ones at GH start (4.8 vs 5.0 years, P<0.01), leaner (weight SDS −3.41 vs −2.95, P<0.001) and had a lower adjusted parental height (−2.44 vs −2.14, P< 0.01). In the 24 years group, compared to term ones, preterm children received higher GH dose (0.38 vs 0.32 mg/kg per week, P<0.05) and presented higher HV SDS only during the first year of therapy (2.49 vs 1.87, P<0.05).
Conclusion: Among very young SGA children, girls and those born preterm were reported to be shorter at start of GH treatment but presented a significant improvement in height during GH therapy.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology