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Growth of infants with neonatal growth hormone deficiency
1Department of Paediatrics, Wilhelmina Children's Hospital, State University, Utrecht, The Netherlands.
Insights
Growth hormone is essential for early infant growth. Some infants with neonatal pituitary issues show normal growth due to incomplete growth hormone insufficiency.
Area of Science:
- Pediatrics
- Endocrinology
- Growth and Development
Background:
- Contradictory reports exist regarding growth hormone dependency in early postnatal growth.
- Neonatal growth hormone deficiency can impact infant development.
Purpose of the Study:
- To investigate the role of growth hormone in early postnatal growth.
- To analyze growth patterns in infants with neonatal growth hormone deficiency.
Main Methods:
- Studied growth curves of 15 infants with neonatal growth hormone deficiency.
- Compared infant growth against the infancy-childhood-puberty (ICP) model standards.
- Assessed growth hormone response to provocation tests in select patients.
Main Results:
- Seven infants (group 1) showed growth parallel to ICP standards.
- Eight infants (group 2) exhibited immediate growth deviation from ICP standards (mean Z-scores at 4 & 9 months: -3.3 & -4.9).
- Decreasing growth hormone levels were observed in group 2 patients; four had documented complete deficiency.
Conclusions:
- Growth hormone is necessary for normal early infant growth.
- Normal growth patterns in some infants with neonatal pituitary dysfunction may result from incomplete growth hormone insufficiency.
Abstract:
In view of contradictory reports on the growth hormone dependency of early postnatal growth we studied the growth curves of 15 infants with neonatal growth hormone deficiency. In seven infants the growth curve was parallel to the standards of the infancy-childhood-puberty (ICP) model (group 1), but in the remaining infants there was an immediate deviation of the growth curve (group 2). In this group the mean (SD) at 4 and 9 months of age was -3.3 (1.1) and -4.9 (1.4), respectively, when compared with the ICP model. The mean birth length in both groups was decreased and five out of 15 had a birth length of less than -2 SD. Serial measurements of the growth hormone response to provocation tests in two patients in group 2 showed decreasing concentrations, while four patients with documented complete growth hormone deficiency belonged to group 2. We conclude that growth hormone is needed for early infant growth and that the normal growth pattern in some infants with neonatal pituitary dysfunction is due to incomplete insufficiency.