GROWTH-HORMONE TREATMENT OF SHORT CHILDREN BORN SMALL-FOR-GESTATIONAL-AGE - METANALYSIS OF 4 INDEPENDENT, RANDOMIZED, CONTROLLED, MULTICENTER STUDIES

A minority of children born small for gestational age (SGA) fail to ac hieve sufficient catch-up growth during infancy and remain short throu ghout childhood, apparently without being growth hormone (OH) deficien t. The effect of GH administration was evaluated over 2 years in short prepubertal children born SGA. The children (n = 244), who were takin g part in four independent multicentre studies, had been randomly allo cated to groups receiving either no treatment or GH treatment at a dai ly dose of 0.1, 0.2 or 0.3 IU/kg (0.033, 0.067 or 0.1 mg/kg) s.c. At b irth, their mean length SD score (SDS) was -3.6 and their mean weight SDS -2.6; at the start of the study, mean ae was 5.2 years, bone age 3 .8 years, height SDS -3.3, height SDS adjusted for parental height -2. 4, weight SBS -4.7 and body mass index (BMI) SDS -1.4. The untreated c hildren had a low-normal growth velocity and poor weight gain. Althoug h bone maturation progressed more slowly than chronological age, final height prognosis tended to decrease, according to height SDS for bone age. GH treatment induced a dose-dependent effect on growth, up to a near doubling of height velocity and weight gain. BMI SDS was not alte red. Bone maturation was also accelerated differentially; however, fin al height prognosis increased in all GH treatment groups. The more pro nounced growth responses were observed in younger children with a lowe r height and weight SDS. In conclusion, GH administration is a promisi ng therapy for normalizing short stature and low weight after insuffic ient catch-up growth in children born SGA. Long-term strategies incorp orating GH therapy now remain to be established.