Growth hormone treatment of children with myelomeningocele.

From the National Cooperative Growth Study database 106 patients (53 boys) with myelomeningocele who were treated with recombinant human growth hormone (GH) at 56 centers were identified. Eighty-one patients (41 boys) were prepubertal at enrollment. The mean pretreatment growth rate (GR) in these prepubertal patients was 4.5 +/- 3.7 cm/yr, and the mean height SD score was -4.0 +/- 1.2. The maximal stimulated GH level was less than 10 micrograms/L in 71% of these patients and less than 7 micrograms/L in 49%. The mean chronologic age was 6.5 +/- 2.9 years, and the mean height age was 3.7 +/- 1.7 years. After GH treatment the year 1 GR in those who remained prepubertal was 8.5 +/- 3.3 cm/yr, a significant increase over baseline (p < 0.01). This increase was sustained through year 4 and remained significant through year 3 (p < 0.01). The height SD score showed sustained significant improvement through year 4, to -2.2 +/- 1.4 (p < 0.001). The GR and SD score for stature improve with GH treatment in children with myelomeningocele.