ESPE Abstracts

Background: Growth hormone (rGH) treatment is an approved growth promoting therapy in children born small for gestational age (SGA) without spontaneous catch-up. SGA infants may be born either full-term or premature. Prematurity is an additional risk factor for adult short stature. Premature children born SGA may potentially be affected by combination of the effects of prematurity and SGA status. There are only few reports on premature SGA children treated with rGH.

Aim: The aim of the study was to compare the growth response in the first year of rGH treatment short premature and mature children born SGA.

Patients and Methods: 60 (32 girls, 28 boys) short prepubertal children born SGA ( mass and/or body birth length< -2 SDS) aged 6,4±1,8 yrs treated with rGH in dose 0,035 mg/kg/day. 23 of them were premature (P-SGA) and 37 full-term (F-SGA). Auxological data were assessed at baseline and after 1 year of rGH treatment.

Results: There was a significant difference in birth mass, length and gestation age between P-SGA and F-SGA group (1563 ±478,6 v 2329,5 ±300,9 g, 42,5 ±5,7 v 48,3 ±3,1 cm and 35,2±2,6 v 39,8±1,3 weeks). There were no differences between MPH (mid-parenteral height) SD between both groups. At the start of rGH treatment P-SGA children were significantly younger (5,2±1,8 v 6,8±1,8 yrs) and shorter (−4,5±1,0 v −3,3±0,7 SD) then F-SGA. The difference between children's height SD and MPH SD in P-SGS and F-SGA children ( −3,2±1,1 v −2,6±1,1) was also significant.

After the first year of treatment P-SGA children were still shorter then F-SGA (−2,7±0,9 v −2,3±0,7 SD, P<0,05), but their mean first-year height gain (ΔHt) SD was not significantly different from F-SGA group (1,4±0,6 v 1,1± 0,5 ΔHt SD, p>0,05). 65,2% P-SGA children and 54% F-SGA children showed ΔHt >1 SD after one year of treatment.

There were no differences in baseline Body Mass Index (BMI) SD and change in BMI SD after one year of rGH treatment between groups.

Conclusions: Premature and full-term short prepubertal SGA children experienced similar height gain in the first year of rGH treatment. P-SGA children qualified to rGH treatment were younger and are shorter then F-SGA children.