Background/Aims: There is limited information about adult height (AH) outcomes and the factors influencing outcomes of growth hormone (GH) therapy in short children born small for gestational age (SGA). Methods: AH (SDS) and Δheight (SDS) from GH start to AH were analyzed in 161 SGA children who had reached AH (55 with Silver-Russell syndrome, SRS). Results: SGA patients treated to AH were started on GH (median) 0.25 mg/kg/week at an age of 7.8 years with a height of –3.8 SDS. AH after 7.7 years was –2.2 SDS and –1.1 SDS below mid-parental height (MPH). AH (SDS) was explained by: height (SDS) at GH start (+), Δheight (SDS) 1st year on GH (+), years on GH (+), maternal height (SDS) (+), length (SDS) at birth (+), and the diagnosis of SRS (–) (explained variability 70%; error 0.6 SD). Gain in height (SDS) was explained by: Δheight (SDS) 1st year on GH (+), years on GH (+), height – MPH (SDS) at GH start (–) (explained variability 60%; error 0.7 SD). Conclusions: Algorithms for AH outcomes provides useful information about the potential of long-term growth on GH in short children born SGA.

Bryan SM, Hindmarsh PC: Normal and abnormal fetal growth. Horm Res 2006;65(suppl 3):19–27.
Albertsson-Wikland K, Karlberg J: Postnatal growth of children born small for gestational age. Acta Paediatr Suppl 1997;423:193–195.
Hokken-Koelega AC, De Ridder MA, Lemmen RJ, Den Hartog H, De Muinck Keizer-Schrama SM, Drop SL: Children born small for gestational age: do they catch up? Pediatr Res 1995;38:267–271.
Wollmann HA, Kirchner T, Enders H, Preece MA, Ranke MB: Growth and symptoms in Silver-Russell syndrome: review on the basis of 386 patients. Eur J Pediatr 1995;154:958–968.
Albanese A, Stanhope R: GH treatment induces sustained catch-up growth in children with intrauterine growth retardation: 7-year results. Horm Res 1997;48:173–177.
Ranke MB, Lindberg A: Growth hormone treatment of short children born small for gestational age or with Silver-Russell syndrome: results from KIGS (Kabi International Growth Study), including the first report on final height. Acta Paediatr Suppl 1996;417:18–26.
Ranke MB: The Kabi Pharmacia International Growth Study: aetiology classification list with comments. Acta Paediatr Scand Suppl 1991;379:87–92.
Niklasson A, Ericson A, Fryer JG, 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 1991;80:756–762.
Prader A, Largo RH, Molinari L, Issler C: Physical growth of Swiss children from birth to 20 years of age. First Zurich longitudinal study of growth and development. Helv Paediatr Acta Suppl 1989;52:1–125.
Ranke MB, Lindberg A, Cowell CT, Wikland KA, Reiter EO, Wilton P, Price DA; KIGS International Board: Prediction of response to growth hormone treatment in short children born small for gestational age: analysis of data from KIGS (Pharmacia International Growth Database). J Clin Endocrinol Metab 2003;88:125–131.
Wit JM, Ranke MB, Kelnar CJH: ESPE Classification of paediatric endocrine diagnoses. Horm Res 2007;68(suppl 2):1–120.
Mukherjee RA, Hollins S, Turk J: Fetal alcohol spectrum disorder: an overview. J R Soc Med 2006;99:298–302.
Eggermann T, Meyer E, Obermann C, Heil I, Schuler H, Ranke MB, Eggermann K, Wollmann HA: Is maternal duplication of 11p15 associated with Silver-Russell syndrome? J Med Genet 2005;42:e26.
Gicquel C, Rossignol S, Cabrol S, Houang M, Steunou V, Barbu V, Danton F, Thibaud N, Le Merrer M, Burglen L, Bertrand AM, Netchine I, Le Bouc Y: Epimutation of the telomeric imprinting center region on chromosome 11p15 in Silver-Russell syndrome. Nat Genet 2005;37:1003–1007.
Tanner JM, Ham TJ: Low birth weight dwarfism with asymmetry (Silver’s syndrome): treatment with human growth hormone. Arch Dis Child 1969;44:231–243.
Lee PA, Blizzard RM, Cheek DB, Holt AB: Growth and body composition in intrauterine growth retardation (IUGR) before and during human growth hormone administration. Metabolism 1974;23:913–919.
Boguszewski M, Albertsson-Wikland K, Aronsson S, Gustafsson J, Hagenas L, Westgren U, Westphal O, Lipsanen-Nyman M, Sipila I, Gellert P, Muller J, Madsen B: Growth hormone treatment of short children born small-for-gestational-age: the Nordic Multicentre Trial. Acta Paediatr 1998;87:257–263.
de Zegher F, Maes M, Gargosky SE, Heinrichs C, Du Caju MV, Thiry G, De Schepper J, Craen M, Breysem L, Lofstrom A, Jonsson P, Bourguignon JP, Malvaux P, Rosenfeld RG: High-dose growth hormone treatment of short children born small for gestational age. J Clin Endocrinol Metab 1996;81:1887–1892.
Lee PA, Chernausek SD, Hokken-Koelega AC, Czernichow P: International small for gestational age advisory board consensus development conference statement: management of short children born small for gestational age. Pediatrics 2003;111:1253–1261.
Clayton PE, Cianfarani S, Czernichow P, Johannsson G, Rapaport R, Rogol A: Management of the child born small for gestational age through to adulthood: a consensus statement of the International Societies of Pediatric Endocrinology and the Growth Hormone Research Society. J Clin Endocrinol Metab 2007;92:804–810.
Saenger P, Czernichow P, Hughes I, Reiter EO: Small for gestational age: short stature and beyond. Endocr Rev 2007;28:219–251.
Sas T, de Waal W, Mulder P, Houdijk M, Jansen M, Reeser M, Hokken-Koelega A: Growth hormone treatment in children with short stature born small for gestational age: 5-year results of a randomized, double-blind, dose-response trial. J Clin Endocrinol Metab 1999;84:3064–3070.
Binder G, Baur F, Schweizer R, Ranke MB: The d3-growth hormone (GH) receptor polymorphism is associated with increased responsiveness to GH in Turner syndrome and short small-for-gestational-age children. J Clin Endocrinol Metab 2006;91:659–664.
Carrascosa A, Esteban C, Espadero R, Fernandez-Cancio M, Andaluz P, Clemente M, Audi L, Wollmann H, Fryklund L, Parodi L; Spanish SGA Study Group: The d3/fl-growth hormone receptor polymorphism does not influence the effect of GH treatment (66 µg/k/day) or the spontaneous growth in short non-GH-deficient small for gestational-age children: results from a two-year controlled prospective study in 170 Spanish patients. J Clin Endocrinol Metab 2006;91:3281–3286.
Tauber M, Ester W, Auriol F, Molinas C, Fauvel J, Caliebe J, Nugent T, Fryklund L, Ranke MB, Savage MO, Clark AJ, Johnston LB, Hokken-Koelega AC; NESTEGG Group: GH responsiveness in a large multinational cohort of SGA children with short stature (NESTEGG) is related to the exon 3 GHR polymorphism. Clin Endocrinol (Oxf) 2007;67:457–461.
Coutant R, Carel JC, Letrait M, Bouvattier C, Chatelain P, Coste J, Chaussain JL: Short stature associated with intrauterine growth retardation: final height of untreated and growth hormone-treated children. J Clin Endocrinol Metab 1998;83:1070–1074.
Rosilio M, Carel JC, Ecosse E, Chaussain JL: Adult height of prepubertal short children born small for gestational age treated with GH. Eur J Endocrinol 2005;152:835–843.
Zucchini S, Cacciari E, Balsamo A, Cicognani A, Tassinari D, Barbieri E, Gualandi S: Final height of short subjects of low birth weight with and without growth hormone treatment. Arch Dis Child 2001;84:340–343.
van Pareren Y, Mulder P, Houdijk M, Jansen M, Reeser M, Hokken-Koelega A: Adult height after long-term, continuous growth hormone (GH) treatment in short children born small for gestational age: results of a randomized, double-blind, dose-response GH trial. J Clin Endocrinol Metab 2003;88:3584–3590.
Carel JC, Chatelain P, Rochiccioli P, Chaussain JL: Improvement in adult height after growth hormone treatment in adolescents with short stature born small for gestational age: results of a randomized controlled study. J Clin Endocrinol Metab 2003;88:1587–1593.
de Zegher F, Hokken-Koelega A: Growth hormone therapy for children born small for gestational age: height gain is less dose dependent over the long term than over the short term. Pediatrics 2005;115:e458–e462.
Dahlgren J, Wikland KA: Final height in short children born small for gestational age treated with growth hormone. Pediatr Res 2005;57:216–222.
Rakover Y, Dietsch S, Ambler GR, Chock C, Thomsett M, Cowell CT: Growth hormone therapy in Silver Russell syndrome: 5 years experience of the Australian and New Zealand Growth database (OZGROW). Eur J Pediatr 1996;155:851–857.
de Ridder MA, Stijnen T, Hokken-Koelega AC: Prediction model for adult height of small for gestational age children at the start of growth hormone treatment. J Clin Endocrinol Metab 2008;93:477–483.
van Dijk M, Mulder P, Houdijk M, Mulder J, Noordam K, Odink RJ, Rongen-Westerlaken C, Voorhoeve P, Waelkens J, Stokvis-Brantsma J, Hokken-Koelega A: High serum levels of growth hormone (GH) and insulin-like growth factor-I (IGF-I) during high-dose GH treatment in short children born small for gestational age. J Clin Endocrinol Metab 2006;91:1390–1396.
Cutfield WS, Lindberg A, Rapaport R, Wajnrajch MP, Saenger P: Safety of growth hormone treatment in children born small for gestational age: the US trial and KIGS analysis. Horm Res 2006;65(suppl 3):153–159.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.