ESPE Yearbook of Paediatric Endocrinology

Brief summary: This retrospective longitudinal study included 5698 patients with multiple height measurements since birth to the near-adult age. The aim was to define different growth patterns of children from birth to 18 years corrected for gestational age, sex and auxological status at birth in order to early identify children at risk for adult short stature. Adult height was significantly reduced in preterm and/or in small-for-gestational-age (SGA) children, with no sex differences. A decreased height-rate during the first year of life in SGA children is a predictor of final short stature.

The population of this study included 5698 children with growth data at birth, at near final height (NFH) and at least 2 further time points during childhood. Children were stratified according to maturity at birth and sex: 526 children preterm children were compared to 5172 children born full-term. The SGA cohort included 1204 children. Children treated with Growth Hormone (GH) were excluded. The determination of the NFH was carried out for girls at an age of 16.2±1.64 and for boys at an age of 16.8±1.45 years.

A total of 741 of 5698 (13%) children presented a NFH < 3rd percentile, amounting to 20.5% (108/526) in the cohort of preterm children and 12% (633/5172) in the cohort of full-term children. The percentage of short children was also higher in children born SGA than those born AGA or LGA (SGA, 33.9%; AGA 11%; LGA, 3.5%; P<0.001). Preterm children had a significantly lower mean NFH than term children (preterm, −0.61 SDS; term, −0.18 SDS). SGA children also had a lower mean NFH than AGA children (SGA, −1.06 SDS; AGA, −0.15 SDS). Of 1204 SGA children, 672 (56%) showed successful catch-up growth (CUG) achieving NFH ≥10th percentile (SGA-CU), and 532 children (44%) did not (SGA-S). The difference in their mean NFH SDS can only partly be explained by the differences in mean mid-parental height SDS (SGA-CU, −0.3; SGA-S, −1.19). The growth-velocity during the first year of life in children born SGA was strongly associated with the final growth outcome. Therefore, careful monitoring of growth during the first 12 months of postnatal life in SGA children could identify those to be destined for remaining permanently short who could benefit from an early start of growth promoting therapies.

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