Short children born prematurely have significant improvements in height and weight during the first year of growth hormone (GH) treatment, researchers report.
Long-term follow-up is still lacking, however.
"Approximately 10% of newborns are born preterm," lead author Dr. Margaret C. S. Boguszewski said.
"Advances in perinatal care ensure that most of them will survive. Therefore, concern today is focused on the development and growth of these children. However, even with all the advances in perinatal care, a substantial growth failure may occur and some children born preterm remain smaller than their term-born peers."
Dr. Boguszewski of Hospital de Clinicas, Curitiba, Brazil and colleagues note that GH may be helpful in such children, but prematurity has usually been an exclusion criterion in clinical trials.
In the Journal of Clinical Endocrinology & Metabolism, they report on data from The Pfizer International Growth Database (formerly the Kabi Pharmacia International Growth Study, and still known as KIGS).
They identified 3,215 prepubertal children who were born with a gestational age of 37 weeks or less and were receiving GH.
Most (1,928) were born at 33 to 37 weeks at a weight appropriate for gestational age, 629 were born before 32 weeks at appropriate weight, 519 had a gestational age of 33 to 37 weeks and were small for gestational age (SGA), and 139 were very premature and were also SGA.
After the first year of GH treatment, all four groups had a significant increase in weight and height velocity, with a median increase in height SDS higher than 0.6. The highest growth velocity, and the greatest increase in weight SD score, were both in the very premature SGA group.
On multiple stepwise regression analysis, "only 27% of the variation in height velocity could be explained by the GH dose," the authors report. This finding, they say, could be explained by the heterogeneity of the diagnoses included in the study.
"The conclusion was that short children born prematurely respond well to the first year of GH treatment, with improvement in growth velocity," said Dr. Boguszewski, "Further studies are needed to collect information about long-term growth response, adult height, and safety of GH therapy in short children after premature birth."