Abstract
Background An increasing body of evidence supports the view that both an adverse intrauterine milieu and rapid postnatal weight gain in children born small for gestational age (SGA) contribute towards the risk for the development of chronic diseases in adult life. Content The aim of this review was to identify and summarize the published evidence on metabolic and cardiovascular risk, as well as risk of impaired cardiac function, intellectual capacity, quality of life, pubertal development and bone strength among children born SGA. The review will then address whether growth hormone (GH) therapy, commonly prescribed to reduce the height deficit in children born SGA who do not catch up in height, increases or decreases these risks over time. Summary Overall, there are limited data in support of a modest beneficial effect of GH therapy on the adverse metabolic and cardiovascular risk observed in short children born SGA. Evidence to support a positive effect of GH on bone strength and psychosocial outcomes is less convincing. Outlook Further evaluation into the clinical relevance of any potential long-term benefits of GH therapy on metabolic and cardiovascular endpoints is warranted.
Highlights
An increasing body of evidence supports that both the intrauterine milieu and rates of weight gain during early childhood may contribute toward the risk of developing chronic diseases in adulthood [1]
In the Hagenau study, metabolic syndrome was found at 22 years of age in 2.3% of individuals born small for gestational age (SGA) compared with 0.3% born appropriate for gestational age (AGA) [15]
Compared with counterparts born AGA, prepubertal children born SGA had significantly lower insulin sensitivity [16], the first phase of insulin response was similar at 48 h after birth [17]
Summary
An increasing body of evidence supports that both the intrauterine milieu and rates of weight gain during early childhood may contribute toward the risk of developing chronic diseases in adulthood [1]. Evidence accumulated over the past two decades has improved the understanding of the link between early life and long-term health [6], as well as showing links with cognitive [7] and psychosocial endpoints These associations with adult disease have raised concerns about children born small for gestational age (SGA) with persistent short stature who may end up receiving growth hormone (GH) therapy. An increasing body of evidence supports the view that both an adverse intrauterine milieu and rapid postnatal weight gain in children born small for gestational age (SGA) contribute towards the risk for the development of chronic diseases in adult life. Outlook: Further evaluation into the clinical relevance of any potential long-term benefits of GH therapy on metabolic and cardiovascular endpoints is warranted
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