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Growth hormone treatment in short children born prematurely--data from KIGS
Margaret C S Boguszewski1, Hanna Karlsson, Hartmut A Wollmann
1Department of Pediatrics, Federal University of Paraná, 80060-900 Curitiba, Brazil. margabogus@uol.com.br
Insights
Short children born prematurely showed significant growth improvement after one year of growth hormone (GH) treatment. Key factors like GH dose and birth weight SDS predicted height velocity response.
Area of Science:
- Pediatrics
- Endocrinology
- Growth Disorders
Background:
- Children born prematurely often experience growth failure.
- Growth hormone (GH) therapy is a potential treatment option for these children.
Purpose of the Study:
- To assess the initial one-year growth response to GH treatment in short, prematurely born children.
- To identify predictors influencing the growth response to GH therapy.
Main Methods:
- Analysis of 3215 prepubertal children born prematurely from the KIGS database.
- Classification into groups based on gestational age (preterm/very preterm) and birth weight (AGA/SGA).
Main Results:
- All four classified groups demonstrated significant increases in weight gain and height velocity after one year of GH treatment.
- Height SDS increased by more than 0.6 in all groups.
- GH dose, GH peak, weight and age at start, parental height, and birth weight SDS explained 27% of height velocity variation.
Conclusions:
- Short children born prematurely exhibit a positive growth response to the first year of GH treatment.
- Further long-term follow-up studies are necessary to fully understand the effects of GH therapy.
Context:
Children born prematurely with growth failure might benefit from GH treatment.
Objectives:
The aim was to evaluate the first year growth response to GH treatment in short children born prematurely and to identify predictors of the growth response.
Design/Patients:
A total of 3215 prepubertal children born prematurely who were on GH treatment were selected from KIGS (The Pfizer International Growth Database), a large observational database. They were classified according to gestational age as preterm (PT; 33 to no more than 37 wk) and very preterm (VPT; <33 wk), and according to birth weight as appropriate for gestational age [AGA; between -2 and +2 sd score (SDS)] and small for gestational age (SGA; -2 SDS or below).
Results:
Four groups were identified: PT AGA (n = 1928), VPT AGA (n = 629), PT SGA (n = 519), and VPT SGA (n = 139). GH treatment was started at a median age of 7.5, 7.2, 6.7, and 6.0 yr, respectively. After the first year of GH treatment, all four groups presented a significant increase in weight gain and height velocity, with a median increase in height SDS higher than 0.6. Using multiple stepwise regression analysis, 27% of the variation in height velocity could be explained by the GH dose, GH peak during provocative test, weight and age at GH start, adjusted parental height, and birth weight SDS. The first year growth response of the children born PT and SGA could be estimated by the SGA model published previously.
Conclusion:
Short children born prematurely respond well to the first year of GH treatment. Long-term follow-up is needed.
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