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Postnatal management of growth failure in children born small for gestational age

Adriane A Cardoso-Demartini1, Margaret C S Boguszewski1, Cresio A D Alves2

  • 1Universidade Federal do Paraná, Departamento de Pediatria, Curitiba, PR, Brazil.

Jornal De Pediatria
|December 15, 2018
PubMed

Insights

Growth hormone therapy is safe and effective for children born small for gestational age (SGA) who do not achieve spontaneous catch-up growth. Early identification of SGA causes is recommended before initiating treatment.

Area of Science:

  • Pediatric Endocrinology
  • Growth and Development
  • Biotechnology

Background:

  • Small size at birth (small for gestational age) can lead to persistent short stature.
  • While many children experience catch-up growth, a significant portion remains short into adulthood.
  • Understanding the etiology and growth consequences of SGA is crucial.

Purpose of the Study:

  • To review the causes and growth outcomes of being born small for gestational age (SGA).
  • To discuss the indications, effectiveness, and safety of biosynthetic growth hormone (GH) therapy in SGA children.
  • To evaluate GH therapy's role in improving adult height for SGA individuals.

Main Methods:

  • Comprehensive literature search across PubMed, LILACS, and SciELO databases (1980-present).
  • Keywords used: "small for gestational age," "intrauterine growth restriction," and "growth hormone."
  • Critical selection of publications by study authors.

Main Results:

  • Most SGA children achieve catch-up growth, but some remain short, risking adult short stature.
  • GH therapy may be indicated for SGA children remaining short after 2-4 years of age.
  • GH treatment improves growth velocity and helps achieve normal childhood and adult height, with better response pre-puberty.

Conclusions:

  • Biosynthetic growth hormone therapy is safe and effective for improving adult height in short SGA children.
  • Identifying the underlying cause of small size at birth is essential before commencing GH treatment.
  • GH therapy offers a viable option for optimizing growth outcomes in select SGA populations.
Abstract

Keywords:
Adult heightBaixa estaturaCatch-upEstatura adultaGrowth hormoneHormônio de crescimentoPequeno para a idade gestacionalShort statureSmall for gestational age

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