Spontaneous Growth in Growth Hormone Deficiency from Birth until 7 Years of Age: Development of Disease-Specific Growth Curves

Abstract

Background: Little is known about spontaneous growth of growth hormone (GH)-deficient children during infancy and childhood. Methods: Retrospectively, we calculated disease-specific pretreatment percentiles for height, weight, BMI and growth velocity of 113 GH-deficient boys and 41 GH-deficient girls from birth until 7 years of age, by mean and standard deviation. Results: Infants with idiopathic GH deficiency (GHD) grow in disease-specific percentile channels. There is a significant difference in length and weight from birth onward compared to regional reference (p < 0.001). Boys’ birth length was 48.7 ± 2.9 cm (p < 0.001; –1.31 ± 1.11 SDS), birth weight was 3.09 ± 0.61 kg (p < 0.01; –0.92 ± 1.19 SDS), and BMI at birth was 12.9 ± 1.7. Girls’ birth length was 48.1 ± 3.4 cm (p < 0.05; –1.17 ± 1.51 SDS), birth weight was 2.92 ± 0.60 kg (p = 0.05; –1.08 ± 1.19 SDS), and BMI at birth was 12.6 ± 2.2. There was a continuous loss of growth velocity, despite a wide variance in the first years, so height deficit became more evident with increasing age. Conclusion: GHD is a congenital disease no matter when height deficit becomes clinically evident, because GH-deficient children grow in disease-specific percentile channels with a highly significantly reduced length and weight, which demonstrates that GH is essential for adequate growth in infancy and early childhood.

Short and Long-Term Effects of Growth Hormone in Children and Adolescents With GH Deficiency

“…About 50% of infants with congenital GHD deviate from the infancy component of growth ( 39 ) and height after one year declines below normal limits ( 40 ). However in many cases in which GHD was detected during childhood, low height velocity could have previously been observed in infancy ( 41 , 42 ). On the other hand, feeding difficulties and failure to thrive may be misleading symptoms in terms of GHD.…”

Physical growth and neurodevelopment during the first year of life: a cohort study of the Japan Environment and Children’s Study

“…The boy-specific association between the conditional relative weight at 4 months and neurodevelopmental delay at 12 months was in line with the association between conditional relative weight and school achievement reported by Adair et al [ 20 ]. The aforementioned endocrine factors have differential effects on somatic and cognitive development between sexes [ 46 , 50 ] and might account at least partially for this association. Conversely, higher conditional variables at 7 and 10 months old did not reduce the risk of neurodevelopmental delay at 12 months, suggesting less susceptibility of the developing brain in late infancy than in early infancy.…”