Published online September 1, 2004
PEDIATRICS Vol. 114 No. 3 September 2004, pp. 683-690 (doi:10.1542/peds.2003-0152-L)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (7)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Arends, N. J.T.
Right arrow Articles by Hokken-Koelega, A. C.S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Arends, N. J.T.
Right arrow Articles by Hokken-Koelega, A. C.S.
Related Collections
Right arrow Premature & Newborn

Head Circumference and Body Proportions Before and During Growth Hormone Treatment in Short Children Who Were Born Small for Gestational Age

Nicolette J.T. Arends, PhD, Venje H. Boonstra, MD and Anita C.S. Hokken-Koelega, PhD

From the Department of Paediatrics, Division of Endocrinology, Erasmus Medical Center/Sophia Children's Hospital, Rotterdam, Netherlands

Objective. Although short children who were born small for gestational age (SGA) seem to have normal body proportions, objective data both before and during growth hormone (GH) treatment are very limited. Therefore, we investigated in a large group of short children who were born SGA the effects of GH treatment versus no treatment on head circumference (HC) and body proportions. Furthermore, we studied differences in linear growth and HC between SGA children who were born with a low birth length and birth weight (SGAL+W) and SGA children who were born with a low birth length only (SGAL).

Methods. An open-labeled, GH-controlled, multicenter study was conducted for 3 years. Non–GH-deficient short SGA children (n = 87), with a mean age (standard deviation) of 5.9 (1.5) years, were randomized to either a GH group (n = 61), receiving GH in a dose of 33 µg/kg/day, or an untreated control group (n = 26). Height; weight; HC; sitting height; armspan; and hand, tibial, and foot size were measured and expressed as standard deviation score (SDS) adjusting for gender and age.

Results. At baseline, all anthropometric measurements, except HC SDS, were significantly lower compared with –2 SDS. During GH treatment, all anthropometric measurements normalized in accordance to the normalization of height SDS. At the start of the study, mean HC SDS was significantly lower in SGAL+W children compared with SGAL children. It is interesting that most (14 of 16) children with an HC SDS less than –2.00 had been born SGAL+W. During GH treatment, the 3-year increase in height, HC, and other anthropometric measurements was comparable between SGAL+W and SGAL children. In both SGAL+W and SGAL control subjects, no changes in SDSs of height, HC, and other anthropometric measurements were found during the 3-year follow-up period.

Conclusions. Untreated short SGA children have normal body proportions with the exception of HC, which is relatively large in many of these children. SGAL+W children still had a smaller HC at the age of 5.9 years compared with SGAL children. Three years of GH treatment induced a proportionate growth resulting in a normalization of height and other anthropometric measurements, including HC, in contrast to untreated SGA control subjects.

Key Words: short stature • small for gestational age • growth hormone • body proportions • head circumference

Abbreviations: SGA, small for gestational age • GH, growth hormone • IGF-I, insulin-like growth factor-I • TH, target height • SGAL+W, SGA children who were born with a low birth length and birth weight • SGAL, SGA children who were born with a low birth length only • HC, head circumference • SDS, standard deviation score • WH, weight for height • SH, sitting height

Accepted Mar 2, 2004.




This article has been cited by other articles:


Home page
 Eur J EndocrinolHome page
K Lagrou, J Vanderfaeillie, C Froidecoeur, M Thomas, G Massa, S Tenoutasse, M Craen, M C Lebrethon, D Beckers, I Francois, et al.
Effect of 2 years of high-dose growth hormone therapy on cognitive and psychosocial development in short children born small for gestational age
Eur. J. Endocrinol., February 1, 2007; 156(2): 195 - 201.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. B. Allen
Growth Hormone Therapy for Short Stature: Is the Benefit Worth the Burden?
Pediatrics, July 1, 2006; 118(1): 343 - 348.
[Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
K. Raile, J. Klammt, A. Schneider, A. Keller, S. Laue, R. Smith, R. Pfaffle, J. Kratzsch, E. Keller, and W. Kiess
Clinical and Functional Characteristics of the Human Arg59Ter Insulin-Like Growth Factor I Receptor (IGF1R) Mutation: Implications for a Gene Dosage Effect of the Human IGF1R
J. Clin. Endocrinol. Metab., June 1, 2006; 91(6): 2264 - 2271.
[Abstract] [Full Text] [PDF]