Growth hormone treatment for children born small for gestational age
- Alan D Rogol, MD, PhD
Alan D Rogol, MD, PhD
- Professor Emeritus
- University of Virginia
- Erick J Richmond, MD
Erick J Richmond, MD
- Chief of Pediatric Endocrinology, National Children's Hospital
- San Jose, Costa Rica
Growth hormone (GH) affects many of the metabolic processes carried out by somatic cells, the best known of which is the effect of increasing body mass. Although generalized growth is stimulated, it is not evenly distributed among the protein, lipid, and carbohydrate compartments. Body protein content increases, total body fat content falls, and an increase in plasma and liver lipid content occurs because of mobilization of free fatty acids (FFA) from peripheral fat stores. The ability of insulin to promote fatty acid synthesis is antagonized by growth hormone.
Most children who were born small for gestational age (SGA) have adequate catch-up growth without pharmacologic intervention. However, for a minority, growth hormone therapy can augment growth parameters.
The indications for and efficacy of exogenous growth hormone treatment in children who were born SGA are reviewed here. The causes of and diagnostic approach to the child with short stature are discussed separately. (See "Causes of short stature" and "Diagnostic approach to children and adolescents with short stature".)
The use of growth hormone for children with other conditions is addressed in separate topic reviews:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- SMALL FOR GESTATIONAL AGE INFANTS
- Fetal GH physiology
- SGA children without catch-up growth
- GROWTH HORMONE TREATMENT
- Growth response
- Dosing and administration
- - Insulin resistance and risk of type 2 diabetes mellitus
- - Cardiovascular risk factors
- - Long-term effects
- SUMMARY AND RECOMMENDATIONS