ESPE Abstracts

Introduction: Small for gestational age (SGA) is a common condition affecting around 10% of all newborns, and it is associated with an increased risk of short stature and other health problems later in life. Growth hormone deficiency (GHD) is a well-known cause of growth failure in children, and it is estimated to affect approximately 1 in 4.000-10.000 children. However, the prevalence of GHD in SGA children with short stature is not well established. Early detection and treatment of GHD in children born SGA is essential to optimize their growth potential. Therefore, this study aimed to determine the prevalence of GHD in SGA children with short stature and also to identify potential predictors that could guide clinicians in GH stimulation testing in this population.

Material and Methods: We conducted a retrospective analysis of children who presented to our clinic with short stature and were born SGA in the previous seven years before commencing growth hormone treatment. The children underwent clinical evaluation, auxological measurements, and hormonal testing. GHD was defined as a peak growth hormone level of less than 10 ng/ml in response to two stimulation tests. All patients were assessed for GHD, as well as for potential predictive factors for GHD in these patients.

Results: Of the 163 children (101 male; 62 female) evaluated, 30 (18.4%) were diagnosed with GHD. The prevalence of GHD was slightly higher in boys (10.4%) than in girls (8.0%). The mean age of our investigated cohort was 8.2± 3.7 years. Statistically significant associations between predicting GHD in short SGA children were observed in the following factors: being born with both small body length and weight for gestational age (P-value 0.028), having low body mass index (median in GHD group -0.9 (IQR 2.4) kg/m2; non GHD group -0.7 (IQR 1.8) kg/m2; P-value 0.017) and low IGF-1 levels (P-value 0.029).

Conclusion: This study provides evidence for a relatively high prevalence of GHD in short children born SGA. Our findings emphasize the importance of early detection and treatment of GHD in children born SGA, with special attention to ones born with both small body length and weight for gestational age, with low BMI and low IGF-1. We recommend that all short children born SGA undergo evaluation for GHD with the final goal of optimizing their growth potential. Further studies are needed to determine the optimal timing and duration of treatment in this population.