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[Infants born with development disorders. What about the long-term statural development? What are the therapeutic
1Service de Pédiatrie, H.U.D.E.R.F., U.L.B.
Insights
Intrauterine growth retardation (IUGR) affects 3% of newborns. While most catch up, growth hormone therapy may help short children, but its long-term effects and psychological impact require further study.
Area of Science:
- Pediatrics
- Endocrinology
- Neonatology
Context:
- Intrauterine growth retardation (IUGR) affects approximately 3% of newborns, defined by birth weight or length below the 3rd percentile or -2 standard deviations.
- Most infants with IUGR (85%) experience spontaneous postnatal catch-up growth within two years.
- Children not achieving catch-up growth by age four typically remain short throughout childhood and into adulthood.
Purpose:
- To evaluate the role of growth hormone (GH) therapy in children with persistent short stature due to IUGR.
- To assess the efficacy of supraphysiological GH doses on growth velocity and potential impact on final height.
- To identify optimal treatment modalities and monitor for potential side effects and psychological impact of GH therapy.
Summary:
- Classical growth hormone deficiency is not typically the cause for lack of catch-up growth in IUGR children.
- A two-year course of GH therapy at supraphysiological doses has shown an increase in growth velocity.
- The long-term effects of GH therapy on final height, optimal treatment strategies, and psychological effects require further investigation.
Impact:
- GH therapy may offer a therapeutic option for children with IUGR-related short stature who do not achieve spontaneous catch-up growth.
- Further research is needed to confirm the impact on final height and establish best practices for GH treatment in this population.
- Careful consideration of potential side effects and psychological well-being is crucial for comprehensive patient management.
Abstract:
Intrauterine growth retardation (IUGR), defined as birth weight and/or length less than 3rd percentile (P) or less than-2 standard deviations (SD), concerns about 3% of newborns. About 85% born IUGR show spontaneous postnatal catch-up to a height > P3 or > -2 SD during the first two years of life. After the age of 4 year, the children without catch-up will remain short up to final height. Classical growth hormone (GH) deficiency usually does not seem responsible for the absence of catch-up in those children. A two-year GH therapy at supraphysiological doses increases growth velocity. The effect of this treatment on final height remains to be studied, as well as optimal treatment's modalities. Attention should be paid on the possible side-effects. Finally, the evaluation of the psychological impact of GH treatment will be critical.