Endocrine Abstracts

Background: Children born small for gestational age (SGA), aged four years or older, who do not undergo a catch-up growth are eligible for growth hormone (GH) treatment. NICE criteria indicate height velocity (HV) should increase by 50% or more from baseline in first year of treatment for treatment to be continued. We reviewed a cohort of GH treated SGA children to ascertain change in growth parameters.

Methods: Baseline, one year, and final height, weight and BMI from children treated with GH was collected. The data was analysed to assess change in HV and height SDS and then furthermore if they had met the recommended criteria for the continuation of treatment.

Results: 17 children had longitudinal data available until final height (8 male; 9 female). The mean age at the start and end of treatment was 7.11 years ±2.52 and 13.37 years ± 2.91 respectively, with treatment lasting for a mean of 6.27 years (range: 3.90 - 9.30). The pre-treatment, one year and final height SDS were, -3.10 ±0.98, -1.72 ±1.46 and -1.85 ±1.22 respectively. The mean pre-treatment and one year height velocities were 4.86 cm/year ±1.79 and 9.6 cm/year ±2.90; (range 6.06 - 12.76) 4 patients had no improvement between starting height (-2.86 SDS) and final height SDS (-3.15 SDS). Of these, 2 also had insufficient HV in the first year to have potentially justified ongoing therapy. The HV in these two individuals was 0.11 cm/year (2%) and 1.14 cm/year (20%)

Conclusion: GH treatment results in an improvement in HV and final height in our cohort of SGA children. The first-year improvement in HV in some children is less than the current recommendations. Continuation criteria could include a pre-calculated HV and target height to be achieved after one year of treatment.