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Izvestia Journal of the Union of Scientists - Varna. Medicine and Ecology Series

Initial results from the treatment with growth hormone of short, small for gestational age children

Darina Krumova, Tanya Zlateva, Kameliya Rankova, Kaloyan Tsochev, Ralitsa Georgieva, Violeta Iotova

Abstract

Introduction: Growth is important indicator of a child`s health. According to the literature, every year between 3 and 7% children are born with birth length and/or weight less than the 10th percentile for the corresponding gestational age. From those born short for gestational age (SGA), one in every ten children cannot catch up in growth. Recently, these children are defined in the literature as “short, SGA children”. Namely, in those children, especially in those untreated, metabolic and cardiovascular changes can be seen with age. In Bulgaria there is still no reimbursement for growth hormone (GH) treatment of this indication, and treatment is supported by a nation-wide charity (The Bulgarian Christmas).

Aim: The aim of this article is to assess patients born SGA, without catch-up growth, regarding the age at start of the treatment, duration and effect of growth hormone treatment.

Patients and Methods: Patients’ data was collected retrospectively from the maintained VECRED record. Statistical analysis was conducted by means of the SPSS programme. The most important factors regarding growth hormone treatment efficacy were assessed.

Results: Currently at the center there are 43 SGA patients with short stature at an average age of 10.3 ± 7.1 y (1.7–40.1), 26 (60.5%) at an average age of 10.3 ± 4.2 y (3.7–17.3) are treated with growth hormone and 17 (39.5%) are just followed. The average age when the GH treatment was initially started is 6.5 ± 3.7 y (1.4–12.1). The gender distribution of the group is nearly 1:1 (22 boys:21 girls). The most common specific diagnosis is Silver-Russell Syndrome (22, 51.2%), followed by Noonan syndrome (3, 6.9%), Di George Syndrome (2, 4.7%), Lowe syndrome, etc. On the average the treatment duration is 39.3 ± 30.2 months (4–120). From the start of the treatment until the current survey, the height of the patients has increased with 1.23 ± 1.8 SDS.

Conclusion: Growth hormone treatment in short SGA children leads to good results and that is why it is currently an accepted standard worldwide. This is also confirmed by the current results.


Keywords

small for gestational age children, short stature, growth hormone

Full Text


References

Fenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr. 2013;13:59. Published 2013 Apr 20. doi:10.1186/1471-2431-13-59

Finken MJJ, van der Steen M, Smeets CCJ, Walenkamp MJE, de Bruin C, Hokken-Koelega ACS, Wit JM. Children Born Small for Gestational Age: Differential Diagnosis, Molecular Genetic Evaluation, and Implications. Endocr Rev. 2018 Dec 1;39(6):851-894. doi: 10.1210/er.2018-00083. Erratum in: Endocr Rev. 2019 Feb 1;40(1):96. PMID: 29982551.

Rapaport R, Wit JM, Savage MO. Growth failure: 'idiopathic' only after a detailed diagnostic evaluation. Endocr Connect. 2021 Mar;10(3):R125-R138. doi: 10.1530/EC-20-0585.

Iotova V. Effects of the low birth weight and length upon postnatal growth and some increased cardiovascular risk factors in adolescents. 2002 PHD thesis, Sofia

Hosagasi NH, Aydin M, Zenciroglu A, Ustun N, Beken S. Incidence of hypoglycemia in newborns at risk and an audit of the 2011 American academy of pediatrics guideline for hypoglycemia. Pediatr Neonatol. 2018;59(4):368-374. doi:10.1016/j.pedneo.2017.11.009

Lee E, Lim Z, Malhotra A. Thrombocytopenia in well small for gestational age neonates. Blood Coagul Fibrinolysis. 2019;30(3):104-110. doi:10.1097/MBC.0000000000000802

Murki S, Vardhelli V, Deshabhotla S, et al. Predictors of length of hospital stay among preterm infants admitted to neonatal intensive care unit: Data from a multicentre collaborative network from India (INNC: Indian National Neonatal Collaborative) [published online ahead of print, 2020 Jul 13]. J Paediatr Child Health. 2020;10.1111/jpc.15031. doi:10.1111/jpc.15031

Willemsen RH, de Kort SW, van der Kaay DC, Hokken-Koelega AC. Independent effects of prematurity on metabolic and cardiovascular risk factors in short small-for-gestational-age children. J Clin Endocrinol Metab. 2008;93(2):452-458. doi:10.1210/jc.2007-1913

Iotova V., B. Toshkina, Y.Yotov, I. Stoeva, K.Petrova. V.Tzaneva. Adiponectin is reduced in 10-year-old children born small for gestational age (SGA). Horm Research 2006; 65 (suppl 4): PO2-596, p. 173 /45nd Annual Meeting of ESPE, Rotterdam, The Netherlands, June 30-July 3, 2006/

Smeets CCJ, van der Steen M, Renes JS, Hokken-Koelega ACS. Bone Mineral Density After Cessation of GH Treatment in Young Adults Born SGA: A 5-Year Longitudinal Study. J Clin Endocrinol Metab. 2017;102(9):3508-3516. doi:10.1210/jc.2017-00269

Lundgren M, Cnattingius S, Jonsson B, Tuvemo T. Intellectual performance in young adult males born small for gestational age. Growth Horm IGF Res. 2004;14 Suppl A:S7-S8. doi:10.1016/j.ghir.2004.03.004

Lee P., Chernausek S. et al. International Small for Gestational Age Advisory Board Consensus Development Conference Statement: Management of Short Children Born Small for Gestational Age, April 24–October 1, 2001; Pediatrics 2003;111;1253

Grimberg A, Huerta-Saenz L, Grundmeier R, Ramos MJ, Pati S, Cucchiara AJ, Stallings VA. Gender Bias in U.S. Pediatric Growth Hormone Treatment. Sci Rep. 2015 Jun 9;5:11099. doi: 10.1038/srep11099. PMID: 26057697; PMCID: PMC4650610.

Ranke MB, Lindberg A. Growth hormone treatment of short children born small for gestational age or with Silver-Russell syndrome: results from KIGS (Kabi International Growth Study), including the first report on final height. Acta Paediatr Suppl. 1996 Oct;417:18-26. doi: 10.1111/j.1651-2227.1996.tb14288.x. PMID: 9055904.

Shepherd S, Saraff V, Shaw N, Banerjee I, Patel L. Growth hormone prescribing patterns in the UK, 2013-2016. Arch Dis Child. 2019 Jun;104(6):583-587. doi: 10.1136/archdischild-2018-316262. Epub 2018 Dec 19. PMID: 30567827.

Ranke MB, Lindberg A, Tanaka T, Camacho-Hübner C, Dunger DB, Geffner ME. Baseline Characteristics and Gender Differences in Prepubertal Children Treated with Growth Hormone in Europe, USA, and Japan: 25 Years' KIGS® Experience (1987-2012) and Review. Horm Res Paediatr. 2017;87(1):30-41. doi: 10.1159/000452887. Epub 2016 Dec 3. PMID: 27915352.

Wakeling EL, Brioude F, Lokulo-Sodipe O, O'Connell SM, Salem J, Bliek J, Canton AP, Chrzanowska KH, Davies JH, Dias RP, Dubern B, Elbracht M, Giabicani E, Grimberg A, Grønskov K, Hokken-Koelega AC, Jorge AA, Kagami M, Linglart A, Maghnie M, Mohnike K, Monk D, Moore GE, Murray PG, Ogata T, Petit IO, Russo S, Said E, Toumba M, Tümer Z, Binder G, Eggermann T, Harbison MD, Temple IK, Mackay DJ, Netchine I. Diagnosis and management of Silver-Russell syndrome: first international consensus statement. Nat Rev Endocrinol. 2017 Feb;13(2):105-124. doi: 10.1038/nrendo.2016.138. Epub 2016 Sep 2. PMID: 27585961.

Jeong I, Kang E, Cho JH, Kim GH, Lee BH, Choi JH, Yoo HW. Long-term efficacy of recombinant human growth hormone therapy in short-statured patients with Noonan syndrome. Ann Pediatr Endocrinol Metab. 2016 Mar;21(1):26-30. doi: 10.6065/apem.2016.21.1.26. Epub 2016 Mar 31. PMID: 27104176; PMCID: PMC4835558.

Çamtosun E, Akıncı A, Demiral E, Tekedereli İ, Sığırcı A. A Case of Cleidocranial Dysplasia with a Novel Mutation and Growth Velocity Gain with Growth Hormone Treatment. J Clin Res Pediatr Endocrinol. 2019 Sep 3;11(3):301-305. doi: 10.4274/jcrpe.galenos.2018.2018.0211. Epub 2018 Nov 23. PMID: 30468148; PMCID: PMC6745455.

Takaki N, Mori J, Matsuo S, Osamura T, Michigami T. Cleidocranial dysplasia with growth hormone deficiency: a case report. BMC Pediatr. 2020 Jan 16;20(1):19. doi: 10.1186/s12887-020-1914-8. PMID: 31948427; PMCID: PMC6966812.

Al Shaikh A, Daftardar H, Alghamdi AA, Jamjoom M, Awidah S, Ahmed ME, Soliman AT. Effect of growth hormone treatment on children with idiopathic short stature (ISS), idiopathic growth hormone deficiency (IGHD), small for gestational age (SGA) and Turner syndrome (TS) in a tertiary care center. Acta Biomed. 2020 Mar 19;91(1):29-40. doi: 10.23750/abm.v91i1.9182




DOI: http://dx.doi.org/10.14748/isuvsme.v26i1.8143

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