# Adult height of children born small for gestational age treated with growth hormone and gonadotropin-releasing hormone analogs in Southern Brazil

## TL;DR

This study examines how growth hormone treatment affects adult height in children born small for gestational age in Brazil.

## Contribution

The study provides insights into the effectiveness of growth hormone therapy for SGA children in a specific geographic region.

## Key findings

- rhGH treatment improved adult height in SGA children, though some did not reach a final height above -2.0 SDS.
- Adult height correlated with height SDS increase and growth velocity during the first year of treatment.
- No significant differences were found between SGA classifications based on birth weight or length.

## Abstract

To evaluate adult height and identify the factors contributing to its
achievement in patients born small for gestational age (SGA) treated with
recombinant human growth hormone (rhGH).

This retrospective study includes data of SGA children treated at a pediatric
endocrinology center. Inclusion criteria were SGA birth (birth length and/or
weight < -1.28 standard deviation score (SDS), absence of catch-up growth
by the age of four years, rhGH treatment for more than 12 months, and
recorded adult height. Birth size SDS was calculated using Intergrowth-21st
(gestational age ≥ 33 weeks) or Fenton (<33 weeks) standards.
Patients with uncontrolled chronic diseases, genetic syndromes, or growth
hormone deficiency were excluded. An increase of 0.6 SDS or more was
considered a positive response.

Twenty-four patients (14 boys) were included, with an average gestational age
of 38.0 (range: 33.0-40.0) weeks, birth weight of -1.3 ± 0.9 SDS, and
birth length of -2.4 ± 0.7 SDS. They were treated with rhGH starting
at an average age of 10.3 ± 2.6 years for a duration of 5.4 ±
2.3 years. Height SDS increased from -2.6 ± 0.4 SDS to -1.2 ±
0.6 SDS, which was comparable to the target height SDS (-1.3 ± 0.9; p
= 0.3). Although 18 children were classified as good responders, 6 did not
achieve a final height SDS > -2.0. Adult height was correlated with the
increment in height SDS and growth velocity during the first year of
treatment. No significant differences were observed between children
classified as SGA by birth weight or length < 10th percentile and those
by weight or length < -2.0 SDS.

In this cohort of children born SGA with short stature, rhGH treatment
effectively improved adult height. Given the diverse causes of being born
SGA, the response to rhGH therapy may vary.