Children born small for gestational age or with very low birth weight: clinical similarities and potential benefits of growth hormone therapy.
The dynamics of early postnatal 'extrauterine' growth in very low birth weight (VLBW) premature infants suggest a switch from mechanisms supporting normal growth during pregnancy to mechanisms promoting postnatal growth. This may permanently affect endocrinological and metabolic homeostasis and development in some children. Altered neurological development and regulation of glucose metabolism in some children born with VLBW appears similar to children born small for gestational age (SGA). In addition, when present, postnatal growth failure has many similarities in both VLBW infants and infants born SGA after intrauterine growth retardation. At 2 years of age, it is very difficult to distinguish between these groups. Increased awareness, with ongoing assessment, of these children is required. In particular, two research areas need special focus in short VLBW children: the effects of growth hormone treatment (which shows dose-dependent efficacy on postnatal growth in short SGA children), and insulin sensitivity (which seems altered, as in short SGA children).
Chatelain
Pierre
P
Hopital Mere-Enfant, University Claude Bernard Lyon 1, Lyon, France. pierre.chatelain@chu-lyon.fr
D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology; D044882:Glucose Metabolism Disorders / Q000209:etiology; D006130:Growth Disorders / Q000209:etiology; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000254:growth & development*; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D007333:Insulin Resistance; D009422:Nervous System Diseases / Q000209:etiology; D011247:Pregnancy
D019382:Human Growth Hormone