ESPE Abstracts

Background: Being born small for gestational age (SGA) has been associated with a reduction in health-related quality of life (HRQoL) and more problem behaviour. Growth hormone (GH) treatment, which leads to a significant improvement in adult height (AH), improves HRQoL and decreases problem behavior in SGA children. However, such results are very limited in SGA adults who were treated with GH during childhood.

Objective: To assess HRQoL and problem behavior in adults born SGA who were treated with GH during childhood in comparison with age-matched untreated controls.

Methods: The study group consistent of 4 different groups: adults born SGA treated with GH during childhood (SGA-GH), adults born SGA with persistent short stature (SGA-S), adults born SGA with spontaneous catch-up growth to a normal adult height (SGA-CU) and adults born with normal birthweight and birthweight (AGA). HRQoL was assessed using TNO-AZL Adults Quality of Life questionnaire (TAAQOL), which consists of 45 items and contains twelve scales; scales were scored from 0-100, 0 indicating the lowest HRQoL. Problem behaviour was assessed using Adolescent Behavior Check List (ABCL). It consists of 113 questions divided in eight subscales and 3 main scales; total problem, externalizing and internalizing problem behavior. Scales were scored from 50-70, 70 indicating the greatest problem behavior.

Results: The group consisted of 335 subjects: 105 SGA-GH, 50 SGA-S, 77 SGA-CU, and 103 AGA. Mean age at follow-up was 28.6 (SGA-GH), 31.8 (SGA-S), 32.7 (SGA-CU) and 32.7 years (AGA), resp. Mean adult height SDS was -1.6 (SGA-GH), -2.4 (SGA-S), -0.2 (SGA-CU) and 0.4 (AGA), resp. Eighty percent of SGA-GH were content with their adult height compared to fifty-six percent in SGA-S (P<0.001). There was no difference in cognitive function, vitality, positive emotions and all other TAAQoL subscales in SGA-GH compared to SGA-S and SGA-CU. No difference between motor function, sleep, social function, daily activities and depressive emotion was found between SGA-GH and AGA. We found no difference in all ABCL subscales in SGA-GH compared to SGA-S. Negative correlation was found between adult height SDS and ABCL total problem score (-0.27, P<0.001). Positive correlation was found between adult height SDS and TAAQoL vitality score (0.18, P<0.001) and positive emotions score (0.17, P<0.001).

Conclusion: SGA-GH were more content with their adult height compared to SGA-S. No differences were found in HRQoL & problem behavior between SGA-GH, SGA-S and SGA-CU. On particular subscales, HRQoL & problem behavior was not different in SGA-GH compared to AGA.