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Title: Early, discontinuous, high dose growth hormone treatment to normalize height and weight of short children born small for gestational age: Results over 6 years
Authors: de Zegher, Francis
Du Caju, MVL
Heinrichs, C
Maes, M
De Schepper, J
Craen, M
Vanweser, K
Malvaux, P
Rosenfeld, RG #
Issue Date: 1999
Publisher: ENDOCRINE SOC
Series Title: Journal of Clinical Endocrinology and Metabolism vol:84 issue:5 pages:1558-1561
Conference: date:Katholieke Univ Leuven, Dept Pediat, Louvain, Belgium; Univ Antwerp, Dept Pediat, B-2020 Antwerp, Belgium; Univ Brussels, Dept Pediat, Brussels, Belgium; Univ Louvain, Dept Pediat, Louvain, Belgium; State Univ Ghent, Dept Pediat, B-9000 Ghent, Belgium; Oregon Hlth Sci Univ, Dept Pediat, Portland, OR 97201 USA
Abstract: Most children born small for gestational age (SGA) normalize their size through spontaneous catch-up growth within the first 2 yr after birth. Some SGA children fail to do so and maintain an abnormally short stature throughout childhood. We have previously reported that high dose GH treatment (66 or 100 mu g/kg.day sc over 2 yr; age at start, 2-8 yr; n = 38) induces pronounced catch-up growth in short children born SGA thereby normalizing their height and weight in childhood. Here, we report on the further prepubertal growth course of these children over the first 4 yr after withdrawal of early, high dose GH treatment. Of the 38 treated children, none developed precocious puberty, and 22 remained prepubertal. Mean age of the latter at start of GH was 4.4 yr, height was -3.7 SD score, and height after adjustment for midparental height was -2.9 so score. Height increased by an average of 2.5 so during the 2 yr of GH treatment and decreased by 0.4 and 0.3 so, respectively, during the first and second year after GH withdrawal. Subsequently, when stature was not extremely short at the start (mean adjusted height so score, -2.7; n = 13), no further GH treatment was given, and the adjusted height was stabilized around - 1.0 sn score; when stature was very short at the start (mean adjusted height, -3.3 so score; n = 9), a second course of GH treatment (66 mu g/kg.day sc) was initiated either 2 yr (n = 5) or 3 yr (n = 4) after initial GH withdrawal. This second course was associated with renewed catch-up growth and also resulted in a mean adjusted height of - 1.0 so score. In each Subgroup, the pattern of the weight course paralleled that of the height course; GH treatment was well tolerated. In conclusion, early, discontinuous, high dose GH treatment appears to be a safe and efficient option to normalize prepubertal height and weight in the majority of short SGA children. It remains to be examined whether the normalized stature will be maintained during pubertal development, either with or without further GH treatment.
ISSN: 0021-972X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Section Newborn (-)
# (joint) last author

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