Does preterm birth influence the response to growth hormone treatment in short, small for gestational age children?

Objective: To investigate whether prematurity has an independent influence on the response to GH treatment in short, small for gestational age (SGA) children.

Design: A longitudinal 3-year GH study.

Patients: A total of 392 prepubertal non-GH-deficient, short SGA children, comprising 138 preterm (< 36 weeks) and 254 term (>or= 36 weeks) children.

Measurements: Height, weight, head circumference, skinfolds and serum IGF-I and IGFBP-3 levels were measured before start of GH treatment and after 6 months, 1, 2 and 3 years of treatment.

Results: Preterm short SGA children were significantly lighter and shorter at birth after correction for gestational age than term short SGA children (P < 0.001). At start of GH treatment, preterm children were significantly shorter than term children when height was corrected for target height (TH). Preterm children were also significantly leaner as shown by a lower body mass index (BMI) standard deviation score (SDS) and a lower sum of four skinfolds SDS. Prematurity had no influence on childhood IGF-I and IGFBP-3 levels. The response to GH treatment was similar for preterm and term SGA children.

Conclusions: Within a population of short SGA children, prematurity is associated with a smaller size for gestational age and a shorter height corrected for TH and leaner phenotype in childhood. The response to GH treatment is similar for preterm and term short SGA children.