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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


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.


small for gestational age children, short stature, growth hormone

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