LINEAR GROWTH IN RESPONSE TO GROWTH-HORMONE TREATMENT IN CHILDREN WITH SHORT STATURE ASSOCIATED WITH INTRAUTERINE GROWTH-RETARDATION - THE NATIONAL COOPERATIVE GROWTH STUDY EXPERIENCE

Short stature commonly follows intrauterine growth retardation (IUGR). Most patients are not growth hormone (GH)-deficient, but GH therapy h as been used in IUGR, Early studies found a heterogeneous increase in initial growth rates that could not be maintained, Results of more rec ent studies with higher doses are more encouraging but do not establis h whether final height is increased. Data from a large number of patie nts in the National Cooperative Growth Study were reviewed to evaluate the response to GH treatment in patients with IUGR-associated short s tature, Two hundred seventy such patients were identified and were cat egorized as those with unclassified IUGR and those with Russell-Silver syndrome/primordial short stature (RSS/PSS), Patients were treated wi th standard doses of recombinant human GH (similar to 0.3 mg/kg per we ek) and were assessed periodically for up to 4 years. The height SD sc ore at baseline in patients with unclassified IUGR was -3.49 +/- 1.16, and their relative height improved with each year of therapy. Patient s who completed 4 years of treatment reached a height SD score of -1.3 2 +/- 0.79. Results were similar in patients with RSS/PSS; their basel ine height SD score was -3.83 +/- 1.05 and improved to -2.10 +/- 0.99 by year 4. Despite these encouraging results, no change occurred in pr edicted adult heights, Furthermore the number of patients who remained in treatment for 4 years decreased substantially, thus limiting the i nterpretation of the data. These data suggest that a beneficial respon se to GH occurs in some patients with IUGR-associated short stature an d that little difference exists in the responses in patients with RSS/ PSS compared with those in patients with unclassified IUGR.