ESPE Abstracts

Introduction: Previous studies have demonstrated varying patterns of growth in children with Growth Hormone Deficiency (GHD), particularly in the first two years of life, a period crucial for growth and development. This study aims to compare the early growth patterns, specifically the rate of catch-down growth in the initial months post-birth, of children diagnosed with GHD. By juxtaposing our findings with existing literature, we seek to deepen the understanding of early growth dynamics in GHD and underline the importance of early therapeutic intervention.

Patients and Methods: Our study cohort consisted of 25 children diagnosed with Growth Hormone Deficiency. The data was collected retrospectively from medical records, including length and weight measurements taken at regular intervals from birth up to 48 months of age. Length and weight were converted to Standard Deviation Scores (SDS) according to age and sex-specific norms. The primary outcome measures were Length SDS (LTSDS) and Weight SDS (WTSDS), focusing on the first two years of life. For comparative analysis, we reviewed similar metrics reported in the literature, including studies by Wit JM & van Unen H (1992), Huet F et al. (1999), and De Luca F et al. (1995). Data analysis involved comparing the mean LTSDS and WTSDS at key age milestones (birth, 2, 4, 6, 12, 18, and 24 months) to determine the pattern and extent of growth decline in the early years.

Results: Our cohort of 25 children demonstrated a marked decline in Length Standard Deviation Scores (LTSDS) from -1.09 at birth to -2.64 by 2 months of age, with a subsequent plateau to -2.48 at 4 months and -2.11 by 6 months. Weight Standard Deviation Scores (WTSDS) paralleled this trend, deteriorating from -1.65 at 2 months to -1.33 by 6 months. This rapid decline in early growth agrees with data from Wit JM & van Unen H (1992), where infants showed an immediate deviation from growth norms with mean LTSDS at 4 and 9 months of -3.3 and -4.9, respectively. Comparing these findings with the literature, De Luca F et al. (1995) observed a 69% incidence of subnormal birth lengths, indicating early onset of GHD possibly before delivery, which corresponds with the early catch-down growth detected in our study. Our data reinforce the notion of a critical GH-dependency of postnatal growth, with the most pronounced decline occurring within the initial months of life, necessitating prompt diagnosis and consideration for early GH therapy intervention.

Conclusion: The study underscores the heterogeneity in growth outcomes among children with GHD and the importance of early and tailored therapeutic strategies to mitigate the early and rapid decline in growth.