It is generally recognized that children born small-for-gestational age (SGA) have a 5–7 times higher risk of short stature than children born at normal size. It has been suggested that the programming of the endocrine axes occurs during critical phases of fetal development and is affected by intrauterine growth retardation. This study was undertaken to characterize the postnatal growth pattern and the final height of children born SGA, as part of a population- based study (n = 3,650), from birth to final height, and to evaluate the hormonal status in another group of prepubertal children born SGA (n = 134) without postnatal catch-up growth. The majority (88%) of ‘healthy’ full-term singleton SGA infants achieved catch-up growth during the first 2 years of life, and most of the increase in height occurred by 2 months of age. The SGA children who remained short at 2 years of age had a higher risk of short stature later in life. The risk of having a short final height (<–2 SDS) was five times higher for children with a low birth weight and seven times higher for those with a low birth length in comparison with children with a normal birth size. Moreover, about 20% of all children of short stature were born SGA. As a group, children born SGA will have a final height, expressed in SDS, as they had during the prepubertal years. This is in contrast to children, who became short postnatally. During puberty, these short children will have a mean height gain of 0.6 SDS for girls and 0.7 SDS for boys. The mean estimated secretion rate for growth hormone (GH) was lower in the short children born SGA compared with the reference groups born at an appropriate size for gestational age, of either short (p < 0.05) or normal stature (p < 0.001). Moreover, in the youngest children born SGA (2–6 years of age) a different pattern of GH secretion was found, with a high basal GH level, low peak amplitude, and high peak frequency. The majority of the children born SGA had levels of GH-binding protein within the range previously reported for normal children. However, the levels of insulin-like growth factor I (IGF-I), IGF-binding protein-3 (IGFBP-3) and leptin were significantly reduced compared with the reference values (p < 0.001, p < 0.01 and p < 0.001, respectively). In conclusion, the low spontaneous GH secretion rate and a disturbed GH secretion pattern, together with low serum levels of IGF-I, IGFBP-3 and leptin, might contribute to the reduced postnatal growth in some of the subgroup of children born SGA who remained short during childhood.

Fitzhardinge PM, Steven EM: The small-for-date-infant. I. Later growth patterns. Pediatrics 1972;49:671–681.
Job JC, Rolland A: Histoire naturelle des retards de croissance à début intrautérin. Arch Fr Pédiatr 1986;43:301–306.
Tenovuo A, Kero P, Piekkala P, Korvenranta H, Sillanpää M, Erkkola R: Growth of 519 small for gestational age infants during the first two years of life. Acta Paediatr Scand 1987;76:636–646.
Fitzhardinge PM, Inwood S: Long-term growth in small-for-date-children. Acta Paediatr Scand Suppl 1989;349:27–33.
Albertsson-Wikland K, Wennergren G, Wennergren M, Vilbergsson G, Rosberg S: Longitudinal follow-up of growth in children born small for gestational age. Acta Paediatr 1993;82:438–443.
Niklasson A, Ericson A, Fryer J, Karlberg J, Lawrence C, Karlberg P: An update of the Swedish Reference Standards for weight, length and head circumference at birth for given gestational age (1977–1981). Acta Paediatr Scand 1981;80:756–762.
Albertsson-Wikland K, Karlberg J: Natural growth in children born small for gestational age with and without catch-up growth. Acta Paediatr Scand Suppl 1994;399:64–70.
Karlberg J, Albertsson-Wikland K: Growth in full-term small-for-gestational-age infants: From birth to final height. Pediatr Res 1995;38:733–739.
Karlberg JPE, Albertsson-Wikland K, Kwan EYW, Lam BCC, Low LCK: The timing of early postnatal catch-up growth in normal, full-term infants born short for gestational age. Horm Res 1997;48(suppl 1):17–24.
Boguszewski M, Rosberg S, Albertsson-Wikland K: Spontaneous 24-hour growth hormone profiles in prepubertal small for gestational age children. J Clin Endocrinol Metab 1995;80:2599–2606.
Boguszewski M, Bjarnason R, Rosberg S, Carlsson LMS, Albertsson-Wikland K: Growth hormone (GH)-binding protein in prepubertal short children born small for gestational age: Effects of growth hormone treatment. J Clin Endocrinol Metab 1997;82:1014–1019.
Boguszewski M, Jansson C, Rosberg S, Albertsson-Wikland K: Changes in serum insulin-like growth factor I and IGF-binding protein–3 levels during growth hormone treatment in prepubertal short children born small for gestational age. J Clin Endocrinol Metab 1996; 81:3902–3908.
Boguszewski M, Dahlgren J, Bjarnason R, Jansson C, Rosberg S, Carlsson L, Carlsson B, Albertsson-Wikland K, on behalf of the Swedish Study Group for Growth Hormone Treatment. Serum leptin concentrations in short children born small for gestational age: Basal levels and relationship to growth response to growth hormone treatment. Eur J Endocrinol 1997;137:387–395.
Albertsson-Wikland K, Rosberg S, Karlberg J, Groth T: Analyses of 24-hour growth hormone (GH) profiles in healthy boys and girls of normal stature. Relation to puberty. J Clin Endocrinol Metab 1994;78:1195–1201.
Albertsson-Wikland K, Rosberg S, Jansson C, Novamo A: Time-resolved immunofluorometric assay of human growth hormone. Clin Chem 1993;39/8:1620–1625.
Carlsson LMS, Rowland AM, Clark RG, Gesundheit N, Wong WLT: Ligand-mediated immunofunctional assay (LIFA) for quantitation of growth hormone binding protein in human blood. J Clin Endocrinol Metab 1991;73:1216–1223.
Blum WF, Breier BH: Radioimmunoassays for IGFs and IGFBPs. Growth Regul 1994;4:11–19.
Mantel N: Chi-square tests with one degree of freedom. J Am Stat Assoc 1963;58:690–700.
Carlsson LMS, Attie KM, Compton PG, Vitangcol RV, Merimee TJ: Reduced concentrations of serum growth hormone-binding protein in children with idiopathic short stature. J Clin Endocrinol Metab 1994;78:1325–1330.
Gluckman PD, Gunn AJ, Cutfield WS, Chatelain PG, Guilbaud O, Ambler GR, Wilton P, Albertsson-Wikland K: Congenital idiopathic growth hormone deficiency associated with prenatal and early postnatal growth failure. J Pediatr 1992;121:920–923.
Lewis UJ, Dunn JT, Bonewald LF, Seavey BK, Vanderlaan WP: A naturally occurring structural variant of human growth hormone. J Biol Chem 1978;253:2679–2687.
Baumann G, Stolar MW, Buchanan TA: Slow metabolic clearance rate of the 20,000-dalton variant of human growth hormone: Implications for biological activity. Endocrinology 1985;117:1309–1313.
Boguszewski CL, Hynsjö L, Johansson G, Bengtsson B-Å, Carlsson LMS: 22-kD growth hormone exclusion assay: a new approach to measurement of non-22-kD growth hormone isoforms in human blood. Eur J Endocrinol 1996;135:573–582.
Boguszewski CL, Jansson C, Boguszewski MCS, Carlsson LMS: Increased proportion of circulating non–22-kildalton growth hormone isoforms in short children: A possible mechanism for growth failure. J Clin Endocrinol Metab 1997;82:2944–2949.
Maffei M, Halaas J, Ravussin E, Pratley RE, Lee GH, Zhang Y, et al: Leptin levels in human and rodent: measurement of plasma leptin and of RNA in obese and weight-reduced subjects. Nature Med 1995;1:1155–1161.
Hassink SG, Sheslow DV, Lancey E, Opentanova I, Considine RV, Caro JF: Serum leptin in children with obesity: Relationship to gender and development. Pediatrics 1996;98:201–203.
Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, et al: Serum immunoreactive-leptine concentrations in normal weight and obese humans. N Engl J Med 1996;334:292–295.
Ferron F, Considine RV, Peino R, Lado IG, Dieguez C, Casanueva FF: Serum leptin concentrations in patients with anorexia nervosa, bulimia nervosa and non-specific eating disorders correlate with the body mass index but are independent of the respective disease. Clin Endocrinol (Oxf) 1997;45:289–293.
Brooke OG, Wood C, Butters F: The body proportions for small-for-dates-infants. Early Hum Dev 1984;10:85–94.
Leger J, Carel C, Legrand I, Paulsen A, Hassan M, Czernichow P: Magnetic resonance imaging evaluation of adipose tissue and muscle tissue mass in children with growth hormone (GH) deficiency. Turner’s syndrome, and intrauterine growth retardation during the first year of treatment with GH. J Clin Endocrinol and Metab 1994;78:904–909.
Petersen S, Gotfredsen A, Knutdsen FU: Lean body mass in small for gestational age and appropriate for gestational age infants. J Pediatr 1988;113:886–889.
Lapillonne A, Braillon P, Claris O, Chatelain PG, Delmas PD, Salle BL: Body composition in appropriate and in small for gestational age infants. Acta Paediatr 1997;86:196–200.
Carro E, Senaris R, Considine RV, Casanueava FF, Dieguez C: Regulation of in vivo growth hormone secretion by leptin. Endocrinology 1997;138:2203–2206.
Bjarnason R, Boguszewski M, Dahlgren J, Gelander L, Kriström B, Rosberg S, Carlsson B, Albertsson-Wikland K, Carlsson LMS: Leptin levels are strongly correlated with those of growth hormone binding protein in prepubertal children. Eur J Endocrinol 1997;137: 68–73.
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