ESPE Abstracts

Introduction: Small-for-gestational-age (SGA) children frequently face challenges in achieving expected growth, with 10% experiencing growth failure and subsequently seeking pediatric endocrinologists for short stature. However, the determinants of growth hormone therapy response in SGA remain unclear

Objective and Method: This study examines the three-year response to growth hormone (GH) therapy and factors affecting growth in 40 SGAchildren. Data on admission and GH initiation ages, initial and follow-up height SDS, annual growth velocity SDS, BA/CA ratio, and changes in height SDS over three years were analyzed retrospectively. Cases with chromosomal anomalies, syndromic conditions, or severe dysmorphisms were excluded.

Results: The age at admission was 7.4 ± 4.5 years, age at initiation of GH was 9.2 ± 4.5 years, and the target height SDS was -1.4 ± 0.8. At the beginning of treatment and in the first, second, and third years, height SDS were -3.2 ± 1.07, -2.86 ± 0.9, -2.5 ± 1, and -2.2 ± 0.7, respectively. The most significant response to GH therapy occurred in the initial year, with growth velocity nearly doubling compared to the pre-treatment period (pre-treatment: 4.8 ± 2.4 cm; post-treatment first, second, and third years: 8.6 ± 2.0 cm, 6.6 ± 2.4 cm, and 5.7 ± 3 cm, respectively). Birth weight, initial GH dose, and results of GH stimulation tests did not significantly affect delta height SDS. Over three years of treatment, the difference between target height SDS and height SDS decreased from -1.7 ± 1.36 to -0.7 ± 1.15. Correlation coefficients and p-values for variables potentially associated with delta height SDS in each year are provided in Table 1.

Conclusion: Among SGA individuals, GH therapy was most effective in the initial year but declined thereafter. The age at therapy initiation was the key determinant of height SDS change. These findings highlight the critical importance of early intervention for achieving catch-up growth.