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Growth hormone treatment of children with myelomeningocele
1Department of Pediatrics, Medical College of Pennsylvania, Pittsburgh, USA.
Insights
Recombinant human growth hormone (GH) significantly improves growth rate and height in children with myelomeningocele. This treatment offers sustained benefits for stature in these patients.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Therapy
- Spinal Cord Defects
Background:
- Myelomeningocele is a severe birth defect impacting growth and development.
- Children with myelomeningocele often exhibit growth deficits.
- Growth hormone (GH) deficiency is common in this population.
Purpose of the Study:
- To evaluate the efficacy of recombinant human growth hormone (GH) in children with myelomeningocele.
- To assess the impact of GH treatment on growth rate (GR) and height standard deviation (SD) score.
Main Methods:
- Retrospective analysis of 106 patients with myelomeningocele from the National Cooperative Growth Study database.
- Focus on 81 prepubertal patients treated with recombinant human GH.
- Analysis of growth rate and height SD score before and during GH treatment up to 4 years.
Main Results:
- Pretreatment mean GR was 4.5 cm/yr, with a mean height SD score of -4.0.
- GH treatment led to a significant increase in GR to 8.5 cm/yr in the first year (p < 0.01).
- Sustained significant improvement in height SD score through year 4, reaching -2.2 (p < 0.001).
Conclusions:
- Recombinant human GH treatment significantly improves growth rate in prepubertal children with myelomeningocele.
- GH therapy leads to sustained and significant improvements in height SD score in this patient group.
- GH treatment is an effective therapeutic option for growth deficits associated with myelomeningocele.
Abstract:
From the National Cooperative Growth Study database 106 patients (53 boys) with myelomeningocele who were treated with recombinant human growth hormone (GH) at 56 centers were identified. Eighty-one patients (41 boys) were prepubertal at enrollment. The mean pretreatment growth rate (GR) in these prepubertal patients was 4.5 +/- 3.7 cm/yr, and the mean height SD score was -4.0 +/- 1.2. The maximal stimulated GH level was less than 10 micrograms/L in 71% of these patients and less than 7 micrograms/L in 49%. The mean chronologic age was 6.5 +/- 2.9 years, and the mean height age was 3.7 +/- 1.7 years. After GH treatment the year 1 GR in those who remained prepubertal was 8.5 +/- 3.3 cm/yr, a significant increase over baseline (p < 0.01). This increase was sustained through year 4 and remained significant through year 3 (p < 0.01). The height SD score showed sustained significant improvement through year 4, to -2.2 +/- 1.4 (p < 0.001). The GR and SD score for stature improve with GH treatment in children with myelomeningocele.
