Is the Response to Growth Hormone in Short Children Born Small for Gestational Age Dependent on Genetic or Maternal Factors?

Mehls, Otto; Lindberg, Anders; Bettendorf, Markus; Doerr, H. G.; Hauffa, Berthold P.; Kaspers, Stefan; Rohrer, Tilman; Stahnke, N; Mb, Ranke

doi:10.1159/000232163

Cited by 4 publications

(3 citation statements)

References 88 publications

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“…Maternal and environmental factors during fetal development as well as genetic defects being responsible for the development of SGA do not seem to influence the responsiveness to GH treatment in later life of children born with SGA without CKD [63]. Likewise, various postnatal growth patterns of children with SGA were found not to be correlated with the response to growth hormone treatment at the age of 6 years [64,65].…”

Section: Growth Hormone Therapymentioning

confidence: 82%

Growth and body composition in very young SGA children

2010

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Infants with a very low birth weight are at risk of a reduced number of nephrons predisposing to kidney disorder, hypertension, and metabolic syndrome. Approximately 3% of infants are born small for gestational age (SGA), defined as birth weight and/or length at least 2 SD below the mean for gestational age (GA), independently of whether these children are born prematurely or at term. About 10% of these children do not show postnatal catch-up growth and remain of short stature during childhood. Most of these infants are not growth hormone (GH)-deficient, but may have GH resistance. Although GH-resistant, the majority of patients benefit from GH therapy, normalize height during childhood, maintain a normal growth velocity during puberty, and attain a normal adult height. To date, GH has been shown to be safe and no significant adverse effects have been demonstrated. Children with congenital chronic kidney disease (CKD) are born with subnormal birth weight and length and about 25% are born SGA. Shortness and need for GH treatment is highly correlated with weight at birth and gestational age. Primary renal disorders modify the response to GH treatment. Analysis of whether SGA is an additional risk factor for CKD regarding the development of hypertension, metabolic syndrome and cardiovascular complications is required.

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Section: Growth Hormone Therapymentioning

confidence: 82%

Growth and body composition in very young SGA children

2010

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“…Essa ausência de diferentes respostas também é observada por alguns autores (26), recomendando-se a utilização dessas subclassificações apenas para investigação etiológica, uma vez que estariam relacionadas a condições de gestação e poderiam influenciar o tipo de parto e de crescimento pós-natal (27).…”

Section: Discussionunclassified

Preditores clínicos do ganho estatural do primeiro ano de tratamento com dose fixa de hormônio de crescimento em crianças nascidas pequenas para idade gestacional

Furtado¹,

Castro

Rodrigues

et al. 2010

Arq Bras Endocrinol Metab

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OBJETIVO: Identificar preditores clínicos associados à recuperação do crescimento no primeiro ano de tratamento com somatropina (rhGH) em um grupo de crianças nascidas pequenas para a idade gestacional (PIG). SUJEITOS E MÉTODOS: Foram avaliadas 39 crianças que estavam em terapia com rhGH por pelo menos um ano (0,33 mg/kg/semana). As variáveis analisadas foram idade cronológica (IC), idade óssea (IO), altura-alvo e escores de desvios-padrão (Z-escore) do peso e comprimento ao nascer, altura, peso e velocidade de crescimento pré e pós-rhGH. RESULTADOS: A terapia com rhGH foi associada a incremento significativo de 0,67 Z-escore (p < 0,01) na estatura nesse primeiro ano. IO e Z-escore de peso ao nascimento foram reconhecidos como preditores dessa resposta, com diferença significativa na variação do Z-escore de estatura entre pré-púberes e púberes (p = 0,016). CONCLUSÃO: Esses dados mostram ganho estatural significativo com dose fixa de rhGH, observando-se melhores resultados quando a terapia foi iniciada na fase pré-puberal.

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“…Das Therapieansprechen auf WH ist bei Kindern mit SGA-Kleinwuchs nach intrauteriner Drogenexposition (Alkohol, Nikotin) letztlich aber nicht bekannt. Fallstudien zeigen bei maternalem Abusus mit Alkohol oder Nikotin einen Trend zu einem unterdurchschnittlichen Therapieansprechen im ersten Behandlungsjahr mit WH [22,35]. Endgrößen von Kindern mit FAS und SGA-Kleinwuchs liegen nach WH-Therapie nach unserer Kenntnis nicht vor.…”

Section: Alkoholabususunclassified

Einfluss von psychosozialen Belastungsfaktoren auf das Längenwachstum

et al. 2021

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Zusammenfassung Hintergrund Wachstum wird durch Hormone, genetische und exogene Faktoren beeinflusst. Fragestellungen Welche Bedeutung haben Psyche, Lebensumstände oder maternaler Drogenkonsum in der Schwangerschaft für das Wachstum von Kindern? Methoden Ergebnisse eines Arbeitstreffens pädiatrischer Endokrinologen mit aktueller Literaturrecherche. Ergebnisse Psychosoziale Deprivation kann bei Kindern mit Kleinwuchs und einem Wachstums-hormon (WH)-Mangel einhergehen, der bei Änderung der Umgebung und unter psychosozialer Unterstützung reversibel ist. Krieg und Migration gehen häufig mit Untergewicht, Wachstumsstörung und schlechter Gesundheitsversorgung einher. Diese bessern sich nach Konfliktende, die Kinder bleiben dennoch häufig zu klein. Alkohol- oder Drogenkonsum von Schwangeren sind mit einem niedrigeren Geburtsgewicht und einem erhöhten Risiko für Früh- und „small for gestational age“ (SGA)-Geburtlichkeit assoziiert. Kinder mit Aufmerksamkeitsdefizit-Hyperaktivitäts-Syndrom (ADHS) zeigten meist nach Beginn einer Stimulanzientherapie eine leichte Wachstumsverlangsamung, erreichen aber eine normale Endhöhe. Schlussfolgerungen Bei Kindern mit idiopathischem Kleinwuchs sollte differenzialdiagnostisch die psychosoziale Genese in Betracht gezogen werden. Eine Stimulanzientherapie bei ADHS wirkt sich demgegenüber auf das Wachstum kaum aus.

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Is the Response to Growth Hormone in Short Children Born Small for Gestational Age Dependent on Genetic or Maternal Factors?

Cited by 4 publications

References 88 publications

Growth and body composition in very young SGA children

Growth and body composition in very young SGA children

Preditores clínicos do ganho estatural do primeiro ano de tratamento com dose fixa de hormônio de crescimento em crianças nascidas pequenas para idade gestacional

Einfluss von psychosozialen Belastungsfaktoren auf das Längenwachstum

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