Evaluation of rhGH therapy in treating small stature as a result of being born small for gestational age (SGA) without catch-up growth
by Ralph Ballard
Abstract – Being born small for gestational age (SGA) refers to being born with a birth weight under two standard deviations for the gestational age and sex of the population. 10% of children born SGA will not experience catch-growth and, if left untreated, this can result in a lower health-related quality of life. Recombinant growth hormone (rhGH) therapy is a common treatment that aims to increase the height velocity of children suffering from short stature. Although many studies have been carried out into the use of rhGH in treating short stature, few have focused solely on its effect on children born SGA. This literature review analysed sources from three databases (n=634) and evaluated the safety, effectiveness and outcomes of rhGH therapy in treating children born SGA. The main conclusions reached were that SGA children usually react well to treatment with a +1.03 SDS change over the first two years, but that the overall outcome will be affected by a number of factors. The treatment was deemed cost-effective for the change in quality of life. Although most side effects were positive - including improved lipid profile, lean mass and Performal IQ - not enough data was present to come to a clear conclusion on metabolism, while the treatment led to an over-correction of insulin sensitivity resulting in subjects being at greater risk of Type 2 diabetes. There was a lack of data on long-term effects. Overall, it appears rhGH is effective in treating children of short stature born SGA without catch-up growth.
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