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Year : 2022  |  Volume : 15  |  Issue : 1  |  Page : 23-28

Are we late in treating with growth hormone short small for gestational age children? Experience of a tertiary care centre

1 Department of Pediatric, Tawam Hospital, Al Ain, UAE
2 Department of Medical Education, University of Health Sciences, Lahore, Pakistan
3 Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
4 Department of Pediatric, Tawam Hospital; Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE

Correspondence Address:
Noura Al Hassani
Department of Pediatric, Division of Endocrinology, Tawam Hospital and College of Medicine and Health Sciences, United Arab Emirates University, P O Box 15258, Tawam Hospital, Al Ain
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/hmj.hmj_33_21

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Background: Short small for gestational age (SGA) children not showing a catch-up growth by 2–4 years of age is an indication for growth hormone (GH) therapy. Objective: The objective of this study was to evaluate at what age short SGA patients present to our paediatric endocrine clinic and start on GH therapy. In addition, we aim to assess their GH response during the 1st year of therapy. Materials and Methods: This retrospective observational study included 108 'SGA' children with 'short stature' who were managed in the paediatric endocrine clinic at Tawam Hospital within 5 years. Patients' electronic medical records were reviewed and their data were retrieved. Results: The median (interquartile range) age at the time of presentation was 6.8 years (3.3, 10.0), with a statistically significant difference between the non-syndromic and syndromic patients, 7.3 (5.2, 10.7) versus 3.2 (1.8, 5.9) years, respectively, whereas the median age at the time of starting GH treatment was 10.7 years (8.1, 13.6), with 47.4% treated at 5–10 years of age and 42.1% at >10 years of age. The mean (±standard deviation) delta height z-score for all treated patients was 0.58 ± 0.40 at 1 year. There was a significant difference in both the mean height at pre and post 1 year of starting GH treatment between the non-syndromic and syndromic groups (P < 0.0001 and 0.003, respectively). Conclusion: The majority of our short SGA patients presented late and were subsequently treated with GH later than the international consensus or guideline recommendations. There is a need for increased awareness to refer these children earlier for a better outcome.

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