Adult height in children born small for gestational age (SGA) with persistent short stature (SGA-SS). Growth hormone treatment outcomes from data of the Czech countrywide REPAR database

Czech version

Authors: Toni Ledjona ^{1,AnetaKodytková 1}; Plachý Lukáš ¹; Jírová Barbora ¹; Hainerová Aldhoon Irena ²; Aleksijevi Darina ³; Černá Jana ⁴; Dvořáková Marcela ⁵; El-Lababidi Eva ²; Kalvachová Božena ⁵; Kocourková Kamila ⁶; Kotvalová Ivana ⁷; Magnová Olga ⁸; Novotná Dana ⁸; Obermannová Barbora ¹; Pomahačová Renata ⁹; Průhová Štěpánka ¹; Souček Ondřej ¹; Strnadel Jiří ⁴; Šíchová Lucie ¹⁰; Škvor Jaroslav ¹⁰; Šnajderová Marta ¹; Šumník Zdeněk ¹; Zapletalová Jiřina ³; Šilar Jiří ¹¹; Koloušková Stanislava ¹; Lebl Jan ¹
Authors‘ workplace: Pediatrická klinika, 2. lékařská fakulta, Univerzita Karlova a Fakultní nemocnice v Motole, Praha ¹; Klinika dětí a dorostu, 3. lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Královské Vinohrady, Praha ²; Dětská klinika, Lékařská fakulta, Univerzita Palackého a Fakultní nemocnice Olomouc ³; Klinika dětského lékařství, Lékařská fakulta, Ostravská univerzita a Fakultní nemocnice Ostrava ⁴; Endokrinologický ústav, Praha ⁵; Dětské oddělení, Nemocnice České Budějovice ⁶; Dětská klinika, Lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Hradec Králové ⁷; Pediatrická klinika, Lékařská fakulta, Masarykova univerzita a Fakultní nemocnice Brno ¨ ⁸; Dětská klinika, Lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Plzeň ⁹; Dětská klinika, Masarykova nemocnice, Krajská zdravotní, a. s., Ústí nad Labem ¹⁰; Institut biostatistiky a analýz, s. r. o., Brno #tyto dvě autorky přispěly ke vzniku článku stejným dílem ¹¹
Published in: Čes-slov Pediat 2023; 78 (S3): 22-29.
Category: Original Papers
doi: https://doi.org/10.55095/CSPediatrie2023/059

Overview

Of children born small for gestational age (SGA) with birth weight and/or birth length below −2 SD, about 10% fail to catch-up after birth. These children remain short over childhood (with height standard deviation score [ht-SDS] below −2.5 SDS) and end up as short adults. They are assigned as SGA-SS (small for gestational age with short stature). European Medicine Agency approved growth hormone therapy in SGA-SS already in 2003.

Out of 1502 SGA-SS children that are registered in the Czech national database of growth hormone recipients REPAR, 397 children (221 boys) already completed growth and achieved near-final height. Growth hormone therapy (median dose 0.034 mg/kg/day) was initiated at age 8.5 years in boys (median; P5-95: 3.2-15.0) and 7.3 years in girls (3.9-13.5). The mean ht-SDS at treatment initiation was −3.21 (SD: 0.91). Treatment was terminated at age 16.2 years in boys (median; P5-95: 14.0-18.7) and 14.3 years in girls (12.4-17.3).

By treatment termination, the patients have had gained 1.59 ht-SDS (mean) and have achieved near-final height −1.62 ht-SDS (SD: 0.97; p<0.0001 if compared to pre-treatment). Thus, majority of patients exceeded −2 SDS at treatment completion and achieved height within normal limits. After adjusting for ht-SDS at age 18 years, their height corresponded to ht-SDS −2.30 (SD: 1.09; p < 0.0001 if compared to pre-treatment). Growth hormone therapy was successful even after this adjustment that mildly underestimates the treatment effect, and led to mean height increase of 0.91 ht-SDS.

Analysis results of the REPAR database confirm efficacy of growth hormone therapy in SGA-SS children and its potential to significantly improve the adult height.

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Labels

Neonatology Paediatrics General practitioner for children and adolescents

Current view on the diagnostics of growth hormone deficiency in childhood and adolescence

Anorexia nervosa from an endocrinologist's point of view

Multiple endocrine neoplasia in childhood

Pubertal growth in children born small for gestational age (SGA) with persistent short stature (SGA-SS). Growth hormone treatment outcomes from data of the Czech countywide REPAR database

Article was published in

Czech-Slovak Pediatrics

2023 Issue S3

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