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Adult height in children born small for gestational age (SGA) with persistent short stature (SGA-SS). Growth hormone treatment outcomes from data of the Czech countrywide REPAR database

Publication at First Faculty of Medicine, Faculty of Physical Education and Sport, Faculty of Medicine in Pilsen, Second Faculty of Medicine, Third Faculty of Medicine |


Of children born small for gestational age (SGA) with birth weight and/or birth length below -2 SD, about 10% fail to catch-up after birth. These children remain short over childhood /with height standard deviation score (ht-SDS) bellow -2.5 SDS/ and end up as short adults. They are assigned as SGA-SS (small for gedtational age with short stature). European Medicine Agency approved grjowth hormone therapy in SGA-SS already in 2003.

Out of 1502 SGA-SS children that are registered in the Czech national database of growth hormone recipients REPAR, 397 children (221 boys) already completed growth and achieved near-final height. Growth hormone therapy (median dose 0.034mg/kg/day) was initiated at age 8.5 years in boys (median; P5-95: 3.2-15.0) and 73. years in girls(3.9-13.5). The mean ht-SDS at treatment initiation was -3.21 (SD:0.91). Treatment was terminated at age 16.2 years in boys (median; P5-95:14.0-18.7) and 14.3 years in girls (12.4-17.3).

By treatment termination, the patients have had gained 1.59 ht-SDS (mean) and have achieved near-final height -1.62 ht-SDS (SD: 0.97; p 0.0001 if compared to pre-treatment). Thus, majority of patients exceeded -2 SDS at treatment completion and achieved height within normal limits. After adjusting for ht-SDS at age 18 years, their height corresponded to ht-SDS -2.30 (SD: 1.09; if compared pre-treatment). Growth hormone therapy was successful even after this adjustment that midly underestimates the treatment effect, and led to mean height increase of 0.91 ht-SDS.

Analysis results of the REPAR database confirm efficacy of growth hormone therapy in SGA-SS children and its potential to significantly improve the adult height.