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Puberty in Growth Hormone-Treated Children Born Small for Gestational Age (SGA)

Department of Pediatrics, Division of Endocrinology (V.B., Y.v.P., A.H.-K.), Sophia Children’s Hospital/Erasmus University, Rotterdam 3015 GJ, The Netherlands; and Department of Epidemiology and Biostatistics (P.M.), Erasmus Medical Center, Rotterdam 3015 GJ, The Netherlands

Address all correspondence to: Venje Boonstra, M.D., Sophia Children’s Hospital, Department of Pediatrics, Division of Endocrinology, Postbus 2060, 3000 CB Rotterdam, The Netherlands. E-mail: v.h.boonstra{at}erasmusmc.nl. Address requests for reprints to: V. H. Boonstra, Sophia Children’s Hospital, Department of Pediatrics, Division of Endocrinology, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.

Seventy-five small for gestational age (SGA) children were studied in a randomized, double-blind, dose-response GH trial with either 1 or 2 mg GH/m²·d. Mean (SD) age at the start of GH therapy was 7.3 (2.2) yr. Data were compared with Dutch reference data.

In SGA boys, mean (SD) age at onset of puberty was 12.0 (1.0) and 11.6 (0.7) yr, and in SGA girls it was 10.9 (1.1) and 10.6 (1.2) yr when treated with 1 and 2 mg GH/m²·d, respectively. SGA boys treated with the lower GH dose started puberty later than the appropriate for gestational age (AGA) controls; for the other GH-dosage groups there was no significant difference in age at onset of puberty compared to AGA controls. The age at menarche and the interval between breast stage M2 and menarche were not significantly different for GH-treated SGA girls compared to their peers. The duration of puberty and pubertal height gain of GH-treated SGA boys and girls were not significantly different between the two GH-dosage groups and were comparable with untreated short children born SGA.

In conclusion, long-term GH therapy in short SGA children has no influence on the age at onset and progression of puberty compared to AGA controls, regardless of treatment with a dose of 1 or 2 mg GH/m²·d. Duration of puberty and pubertal height gain were not significantly different between the GH-dosage groups.

This work was supported by Novo Nordisk A/S (Bagsvaerd, Denmark).

This study was presented at the 41st Annual Meeting of the European Society for Paediatric Endocrinology (ESPE), Madrid, Spain, 2002.

Abbreviations: AGA, Appropriate for gestational age; AH, adult height; BMI, body mass index; CI, confidence interval; P10, 10th percentile; P50, 50th percentile; P90, 90th percentile; RUS, radius, ulna, short-bones score; SDS, SD score; SGA, small for gestational age; TH, target height.

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