Pubertal growth in children born small for gestational age (SGA) with persistent short stature (SGA-SS). Growth hormone treatment outcomes from data of the Czech countywide REPAR database
Authors:
Kodytková Aneta 1,LedjonaToni 1; Plachý Lukáš 1; Jírová Barbora 1; Hainerová Aldhoon Irena 2; Aleksijevi Darina 3; Černá Jana 4; Dvořáková Marcela 5; El-Lababidi Eva 2; Kalvachová Božena 5; Kocourková Kamila 6; Kotvalová Ivana 7; Magnová Olga 8; Novotná Dana 8; Obermannová Barbora 1; Pomahačová Renata 9; Průhová Štěpánka 1; Souček Ondřej 1; Strnadel Jiří 4; Šíchová Lucie 10; Škvor Jaroslav 10; Šnajderová Marta 1; Šumník Zdeněk 1; Zapletalová Jiřina 3; Šilar Jiří 11; Koloušková Stanislava 1; Lebl Jan 1
Authors place of work:
Pediatrická klinika, 2. lékařská fakulta, Univerzita Karlova a Fakultní nemocnice v Motole, Praha
1; Klinika dětí a dorostu, 3. lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Královské Vinohrady, Praha 3 Dětská klinika, Lékařská fakulta, Univerzita Palackého a Fakultní nemocnice Olomouc
2; Klinika dětského lékařství, Lékařská fakulta, Ostravská univerzita a Fakultní nemocnice Ostrava
4; Endokrinologický ústav, Praha
5; Dětské oddělení, Nemocnice České Budějovice
6; Dětská klinika, Lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Hradec Králové
7; Pediatrická klinika, Lékařská fakulta, Masarykova univerzita a Fakultní nemocnice Brno
8; Dětská klinika, Lékařská fakulta, Univerzita Karlova a Fakultní nemocnice Plzeň
9; Dětská klinika, Masarykova nemocnice, Krajská zdravotní, a. s., Ústí nad Labem
10; Institut biostatistiky a analýz, s. r. o., Brno, #tyto dvě autorky přispěly kevzniku článku stejným dílem
11
Published in the journal:
Čes-slov Pediat 2023; 78 (S3): 30-36.
Category:
Original Papers
doi:
https://doi.org/10.55095/CSPediatrie2023/058
Summary
Both pre-pubertal growth and magnitude of the pubertal growth spurt are the prerequisites of potential of growth hormone therapy to optimize final height. We analyzed impact of pre-pubertal and pubertal growth components on the total effect of growth hormone therapy in a cohort of 397 children (221 boys) registered in the Czech national database of growth hormone recipients REPAR. All were born small for gestational age, had persistent short stature in childhood (SGA-SS) and already achieved their near-final height. We separately evaluated children according to parental heights (with both parents over −2 ht-SDS, one below −2 ht-SDS, both below −2 ht-SDS) and according to their size at birth – low birth weight, low birth length, low both parameters.
Up to treatment completion, treatment led to a height gain of 1,59 ht-SDS; of this, the pre-pubertal gain was 1,57 ht-SDS. Thus, ht-SDS remained unchanged within puberty, despite continuous growth hormone administration. The final ht-SDS gain adjusted for age 18 years was 0,91 (all three parameters p<0.0001 if compared to pre-treatment). Children with both parents taller than −2 SD and children with exclusively low birth weight had significantly better treatment outcomes.
Analysis results of the REPAR database confirm efficacy of growth hormone therapy in SGA-SS children. The treatment success is based on pre-pubertal growth component. Therefore, a careful follow-up of children born SGA and a timely initiation of growth hormone therapy in early childhood are of crucial importance.
Keywords:
small-for-gestational-age, SGA-SS, growth hormone, puberty, pubertal growth spurt, adult height
Zdroje
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Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
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