title: Puberty and Pubertal Growth in GH-treated SGA Children: Effects of 2 Years of GnRHa Versus No GnRHa.
abstract: Most studies on puberty in children born small for gestational age (SGA) report height and age at onset of puberty. GH-treated SGA children with an adult height (AH) expectation below -2.5 SDS at onset of puberty can benefit from an additional 2 years of GnRH analog (GnRHa) treatment. There are no data on puberty and growth after discontinuation of GnRHa treatment in GH-treated SGA children.
  
  
  
  This study aimed to investigate the effects on puberty and pubertal growth of 2 years GnRHa vs no GnRHa in GH-treated SGA children.
  
  
  
  This was a GH trial involving 76 prepubertal short SGA children (36 girls) treated with GH. Thirty-two children received additional GnRHa for 2 years. Pubertal stages were 3-monthly assessed according to Tanner.
  
  
  
  Age, bone age, and median height at pubertal onset were lower in girls and boys in the GH/GnRHa group compared with the GH group. In girls and boys treated with GH/GnRHa, pubertal duration after stop of GnRHa treatment was shorter than pubertal duration in those with GH only (40.9 vs 46.7 mo; P = .044; 50.8 vs 57.5 months; P = .006; respectively). Height gain from onset of puberty until AH, including height gain during 2 years of GnRHa treatment, was 25.4 cm in girls and 33.0 cm in boys, which was 6.6 cm more than girls and boys treated with GH only. AH was similar in children treated with GH/GnRHa compared with those with GH only.
  
  
  
  GH-treated SGA children who start puberty with an AH expectation below -2.5 SDS and are treated with 2 years of GnRHa have a shorter pubertal duration after discontinuation of GnRHa compared with pubertal duration in children treated with GH only. Height gain from onset of puberty until AH is, however, more due to adequate growth during 2 years of GnRHa treatment resulting in a similar AH as children treated with GH only.
authors.affiliation: Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.-K.), 3016 AH Rotterdam, The Netherlands; and Erasmus University Medical Center-Sophia Children's Hospital (M.v.d.S., A.C.S.H.-K.), 3015 CN Rotterdam, The Netherlands.
authors.forename: Manouk
authors.initials: M
authors.lastname: van der Steen
authors.affiliation: Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.-K.), 3016 AH Rotterdam, The Netherlands; and Erasmus University Medical Center-Sophia Children's Hospital (M.v.d.S., A.C.S.H.-K.), 3015 CN Rotterdam, The Netherlands.
authors.forename: Annemieke J
authors.initials: AJ
authors.lastname: Lem
authors.affiliation: Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.-K.), 3016 AH Rotterdam, The Netherlands; and Erasmus University Medical Center-Sophia Children's Hospital (M.v.d.S., A.C.S.H.-K.), 3015 CN Rotterdam, The Netherlands.
authors.forename: Danielle C M
authors.initials: DC
authors.lastname: van der Kaay
authors.affiliation: Dutch Growth Research Foundation (M.v.d.S., A.J.L., D.C.M.v.d.K., A.C.S.H.-K.), 3016 AH Rotterdam, The Netherlands; and Erasmus University Medical Center-Sophia Children's Hospital (M.v.d.S., A.C.S.H.-K.), 3015 CN Rotterdam, The Netherlands.
authors.forename: Anita C S
authors.initials: AC
authors.lastname: Hokken-Koèelega
mesh_terms: D000293:Adolescent; D001827:Body Height / Q000187:drug effects*; D002648:Child; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives; D006130:Growth Disorders / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007236:Infant, Small for Gestational Age; D016729:Leuprolide / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D011627:Puberty / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D019382:Human Growth Hormone; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide