Craniofacial growth in short children born small for gestational age: two years follow-up after high-dose growth hormone treatment.

The craniofacial growth of 17 children born small for gestational age (SGA), who had received high-dose growth hormone (GH) treatment, was studied during the post-treatment phase. The preceding GH treatment consisted of a daily s.c. dose of either 0.2 or 0.3 IU/kg for 2 years. The group consisted of 9 girls and 8 boys with a mean (range) age of 6.9 yr (4-10 years) at the start of the post-treatment period, a mean (SD) bone age of 6.3 (2.1) years, and a mean (SD) height for chronological age of -1.0 (0.6) SDS. During the post-treatment period of 2 years, a catch-down effect was found for all linear craniofacial measurements in both treatment groups, even for the components that had not presented accelerated growth during GH treatment. Major growth vectors, such as the posterior total face height (S-Go) and the overall length of the mandible (Art-Pog), showed a low growth velocity, while minor growth parameters remained almost unchanged during this period. The angular measurements showed no significant changes during this period. It can be concluded that craniofacial growth in short SGA children showed, after a period of GH-induced acceleration, a catch-down period when GH administration is stopped. Despite this low post-treatment growth velocity, the craniofacial linear measurements in lateral aspect, remained larger than in untreated children.