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Dospělá výška dětí, které se narodily malé na svůj gestační věk (SGA), s malou výškou v dětství (SGA-SS). Výsledky léčby růstovým hormonem z dat české národní databáze REPAR
Title in English | 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 |
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Authors | |
Year of publication | 2023 |
Type | Article in Periodical |
Magazine / Source | Česko-slovenská pediatrie |
MU Faculty or unit | |
Citation | |
Web | https://www.prolekare.cz/casopisy/cesko-slovenska-pediatrie/2023-s3/dospela-vyska-deti-ktere-se-narodily-male-na-svuj-gestacni-vek-sga-s-malou-vyskou-v-detstvi-sga-ss-vysledky-lecby-rustovym-hormonem-z-dat-ceske-narodni-databaze-repar-136398 |
Doi | http://dx.doi.org/10.55095/CSPediatrie2023/059 |
Keywords | small-for-gestational-age; SGA-SS; growth hormone; adult height; adjusted final height |
Description | 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] below -2.5 SDS) and end up as short adults. They are assigned as SGA-SS (small for gestational age with short stature). European Medicine Agency approved growth 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 0.034 mg/kg/day) was initiated at age 8.5 years in boys (median; P5-95: 3.2-15.0) and 7.3 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; p < 0.0001 if compared to pre-treatment). Growth hormone therapy was successful even after this adjustment that mildly 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. |