ESPE2022 Poster Category 1 Late Breaking (25 abstracts)
Ten years of growth hormone treatment in children born small for gestational age with persistent short stature- results of a Portuguese multicenter study
Catarina Diamantino 1 , Francisco Caetano 1 , Ana Luísa Leite 2 , Carla Costa 3 , Paula Vieira 4 , Sandrina Novais 5 , Teresa Borges 6 & Carla Pereira 7
1Unit of Pediatric Endocrinology and Diabetes - Hospital de Dona Estefânia- Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal; 2Department of Pediatric Endocrinology and Diabetes – Centro Hospitalar Vila Nova de Gaia, Vila Nova de Gaia, Portugal; 3Department of Pediatric Endocrinology and Diabetes – Centro Hospitalar Universitário de São João, Porto, Portugal; 4Department of Pediatric Endocrinology and Diabetes – Hospital São Francisco Xavier, Centro Hospitalar Universitário Lisboa Ocidental, Lisboa, Portugal; 5Department of Pediatric Endocrinology and Diabetes – Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal; 6Department of Pediatric Endocrinology and Diabetes – Centro Materno Infantil do Norte, Centro Hospitalar do Porto, Porto, Portugal; 7Department of Pediatric Endocrinology and Diabetes – Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
Background: Growth hormone (GH) treatment is indicated for children who are born small for gestational age (SGA) and fail to achieve sufficient catch-up growth during infancy and remain short throughout childhood.
Aims: To evaluate the effect of GH treatment in a large, multicentric, Portuguese SGA children cohort and to analyze for correlation between GH treatment response and clinical factors.
Methods: A retrospective, multicentric study was conducted from 2011 to 2020. The study group included children born small for gestational age (birth weight and/or length at least 2 SDS below the mean for sex and gestational age) with persistent short stature after 4 years of age, who underwent GH treatment for at least one year.
Results: A total of 111 children were enrolled. The mean gestational age was 37.50±4,2 weeks. Birth weight and length standard deviation score (SDS) were -1,85±0,9 and -2,52 ±0,78 respectively. At the start of GH treatment, the mean chronological age was 7,26±2,76 years, bone age (BA) was 4.64±2,91 years, and the mean height SDS was -3,19±0.78. The mean initial GH dose was 32,34 ± 5,34 mg/kg/dia. The mean height SDS change (ΔHt SDS) was 0,59±0,58 after the first year of treatment (n=111) and 0,27±0,33 after the second year (n=94). Up to a 27% of patients showed a poor response in the first year (ΔHt SDS < 0,3). The first year growth response was positively correlated with younger age (P=0,033) and lower BA (P=0,037) at the start of treatment; GH dose was not correlated with height SDS change (P=0,288). Nineteen patients (17% of the sample) had attained final height; their mean initial height SDS was -3,04±0,77 and they achieved a mean height SDS of -1,84± 0,94.
Conclusions: In the first year, there was a good response to GH treatment in the majority (73%) of patients (ΔHt SDS > 0,3). In this sample, GH doses were very similar and GH dose was not an important predictor of growth response. Early initiation of GH treatment improved growth outcomes so monitoring growth of SGA children is crucial for an earlier GH treatment.
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