Near-adult height after growth hormone treatment in children born prematurely—data from KIGS

Abstract

Context: Children born prematurely have been treated with growth hormone (GH), and a significant improvement in height during the first years of treatment has been described. Objective: To evaluate the influence of prematurity on near-adult height (NAH) after GH treatment. Design: KIGS (Pfizer International Growth Database) was queried for children born preterm treated with GH. Setting: KIGS database. Patients: A total of 586 children short in stature born preterm with various GH status and with available gestational age (GA), birth weight, and NAH, all treated with GH. Intervention: GH treatment. Main Outcome Measure: NAH. Results: Values were expressed as median. From the 586 children included, 482 born appropriate for GA (AGA; median age 8.26 years) and 104 born small for gestational age (SGA) (median age 8.54 years); 66.6% of preterm AGA had GH peak < 7 µg/L during a provocation test, whereas only 8.6% of preterm SGA. Change in height standard deviation scores (SDS) from GH start to NAH after 8.04 years of GH treatment was 1.82 in preterm AGA. Respective values were 7.08 years and 1.08 SDS for preterm SGA (P < 0.001); 57% of the variability of the growth response to NAH could be explained, and the distance to parental height was the strongest predictor. No significant changes in height SDS were observed from puberty start to NAH. No correlation was found with GA. GH treatment was well tolerated. Conclusion: GH treatment resulted in significant improvement in height in children born preterm, particularly during prepubertal years and for those with GH deficiency. The degree of prematurity did not influence the growth response.