Growth Hormone Treatment in Children Born Small for Gestational Age (SGA)

Abstract

Introduction: Growth failure is a common consequence in small for gestational age (SGA) children. Patients and Methods: The growth patterns and serum insulin like growth factor 1 (IGF1) concentrations before and after the 1st year under growth hormone treatment of 32 short stature SGA born children have been evaluated. In addition, we investigated the insulin like growth factor 1 receptor (IGF1R) exon 2 as a hotspot for IGF1R genetic alterations. It is of note that no dysmorphic features were observed in this group of children. Results: The tests for pituitary reserve were within normal ranges for all 32 patients. Growth hormone (GH) treatment (0.037 mg/kg/day) was initiated at the mean age of 9.32±3.19 years. Growth velocity increased yearly from −1.80 SDS after the first year to −0.03 SDS in the sixth year of treatment. Their IGF1 serum concentrations before treatment were age and sex appropriate, while during treatment a significant increase was observed fitting in the upper third of the normal range: before the treatment IGF1 SDS was 0.84±1.78 after 1st year the concentrations increased to IGF1 SDS 0.94±2.23. No genetic alterations were found in the IGF1R exon 2 by PCR analysis. Conclusions: Herein we present 32 short stature SGA children with no dysmorphic features treated with GH. They all had increased growth velocity and entered the normal growth range on their growth charts. No side-effects were observed. GH treatment in children with no genetic alterations on the IGF1R exon 2 is safe and efficient in treating SGA children with short stature.

Intrauterine multi-metal exposure is associated with reduced fetal growth through modulation of the placental gene network

“…Being born small for gestational age (SGA) is a major determinant of childhood and later life morbidity, including metabolic syndrome, neurodevelopmental deficits and coronary heart disease (Arcangeli et al 2012; Jancevska et al 2012). Established risk factors known to impact fetal growth include maternal age, parity and ethnicity (Jancevska et al 2012).…”

“…Being born small for gestational age (SGA) is a major determinant of childhood and later life morbidity, including metabolic syndrome, neurodevelopmental deficits and coronary heart disease (Arcangeli et al 2012; Jancevska et al 2012). Established risk factors known to impact fetal growth include maternal age, parity and ethnicity (Jancevska et al 2012). In addition to maternal characteristics, gestational exposure to environmental pollutants through maternal ingestion and inhalation are also known to play a role (Chou et al 2011; Lauritzen et al 2016; Peelen et al 2016; Stillerman et al 2008).…”

Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight

“…Specifically, LBW has been reported to be associated with increased risks for diseases including cardiovascular disease, type 2 diabetes, end-stage renal disease, and schizophrenia (Negrato and Gomes, 2013;Alexander et al, 2014;Zhang et al, 2014). Jancevska et al (2012) reported that SGA people had an increased incidence of metabolic syndrome, coronary artery disease, stroke, low bone density, and osteoporosis. A high BW has been regarded as associated with increased risks of type 2 diabetes and obesity (Johnsson et al, 2015).…”

Statistical Analysis of Birth Weight and Gender of Newborn Infants

“…Babies with LBW or babies born as small-forgestational-age are disadvantaged early in life. They have higher risks of hypoglycemia, hyperbilirubinemia, respiratory distress syndrome, low APGAR score with the resultant poor quality of life with approximately 20 times increased risk of neonatal death more than babies born as appropriate-for-gestational-age weight [8,9,10,11]. Negrato and Gomes have demonstrated a clear relationship between LBW and increased risk of many diseases later in life, such as insulin resistance, cardiovascular diseases, renal diseases [12], etc.…”