Adult height in short children born small for gestational age treated with growth hormone

Area of Science:

• Pediatric Endocrinology
• Growth Hormone Therapy
• Child Development

Background:

• Recombinant human growth hormone (rhGH) is effective for small for gestational age (SGA) children but shows variable responses.
• Understanding factors influencing long-term response and final adult height is crucial.

Purpose of the Study:

• To evaluate adult height and identify factors determining long-term response to rhGH in SGA children.
• To analyze the impact of treatment timing (pre-puberty vs. puberty) on final height outcomes.

Main Methods:

• Retrospective study of 80 SGA children with short stature treated with rhGH.
• Follow-up until adult height was achieved.
• Analysis of factors including initial measurements, bone age, IGF-I levels, and growth velocity during treatment.

Main Results:

• Pre-pubertal treatment led to higher adult height compared to pubertal treatment.
• Optimal height gain was observed in children treated for at least two years pre-puberty.
• Factors associated with greater height gain included lower initial BMI, younger chronological and bone age, greater distance to target height, and higher early growth velocity.
• A growth velocity increase of ≥3cm in the first year best correlated with long-term response.

Conclusions:

• rhGH treatment in SGA children results in variable but beneficial increases in adult height.
• Pre-pubertal treatment initiation is associated with superior outcomes, independent of pituitary GH response.