Concerns, expectations and perception regarding stature, physical appearance and psychosocial functioning before and during high-dose growth hormone treatment of short pre-pubertal children born small for gestational age.
Body Height; Child; Child, Preschool; Female; Human Growth Hormone/therapeutic use; Humans; Infant, Newborn; Infant, Small for Gestational Age/growth & development/psychology; Male; Parents/psychology; Patient Satisfaction; Perception; Psychomotor Performance; Social Behavior
Abstract :
[en] BACKGROUND/AIMS: Few data are available about parental concerns and psychosocial functioning of young children born small for gestational age (SGA) treated with growth hormone (GH). The present study focused on the perception of short stature and the concerns and expectations of the parents regarding GH treatment. METHODS: Forty prepubertal short SGA children, randomized into a GH-treated and a GH-untreated group, and their parents were evaluated by a questionnaire and a semi-structured interview at start and after 2 years of follow-up. RESULTS: Before start, 85% of the parents were concerned about short stature, 76% expected an increase in adult height of > or =10 cm and 81% expected a positive impact on well-being. Half of the parents expressed fears regarding GH treatment. After 2 years, more parents of treated children reported obvious growth and physical changes, and fewer parents reported teasing because of short stature. An improvement of well-being was reported by half of the parents of treated and untreated children. Fears about GH treatment disappeared almost completely. CONCLUSION: The perspective of GH treatment induced major adult height expectations. In treated children, the physical effects of GH treatment became obvious, teasing because of short stature decreased and initial concerns about short stature and GH therapy decreased.
Concerns, expectations and perception regarding stature, physical appearance and psychosocial functioning before and during high-dose growth hormone treatment of short pre-pubertal children born small for gestational age.
Fitzhardinge PM, Steven EM: The small-for-date infant. Neurological and intellectual sequelae. Pediatrics 1972;50:50-56.
Hutton JL, Pharoah POD, Cooke RWI, Stevenson RC: Differential effects of preterm birth and small for gestational age on cognitive and motor development. Arch Dis Child 1997;76:75-81.
Low JA, Handley-Derry MH, Burke SO, Peters RD, Pater EA, Killen HL, Derrick EJ: Association of intrauterine fetal growth retardation and learning deficits at age 9 to 11 years. Am J Obstet Gynecol 1992;6:1499-1505.
Smedler AC, Faxelius G, Bremme K, Lagerstrom M: Psychological development in children born after severe intrauterine growth retardation: a 10-year follow-up. Acta Paediatr 1992;81:197-203.
Strauss RS: Adult functional outcome of those born small for gestational age: twenty-six year follow-up of the 1970 British birth cohort. JAMA 2000;283:625-632.
Carel JC, Chatelain P, Rochiccioli P, Chaussain JL: Improvement in adult height after growth hormone treatment in adolescents with short stature born small for gestational age: Results of a randomized controlled study. J Clin Endocrinol Metab 2003;88:1587-1593.
Ahlgren J, Albertsson Wikland K: Final height in short children born small for gestational age treated with growth hormone. Pediatr Res 2004;57:216-222.
de Zegher F, Du Caju M, Heinrichs C, Maes M, De Schepper J, Craen M, Vanweser K, Malvaux P, Rosenfeld RG: Early, discontinuous, high dose growth hormone treatment to normalize height and weight of short children born small for gestational age: results over 6 years. J Clin Endocrinol Metab 1999;84:1558-1561.
Van Pareren Y, Mulder P, Houdijk M, Jansen M, Reeser M, Hokken-Koelega A: Adult height after long term, continuous growth hormone (GH) treatment in short children born small for gestational age: results of a randomized, double-blind, dose-response GH trial. J Clin Endocrinol Metab 2003;88:3584-3590.
Boulton TJC, Dunn SM, Quigley CA: Perceptions of self and short stature: effects of two years of growth hormone treatment. Acta Paediatr Scand 1991;377:20-27.
Tanaka T, Matsuo N, Seino Y, Fujieda K, Yokoya S, Tachibana K: Growth-promoting and psychological effects of high-dose growth hormone treatment in children with intrauterine growth retardation. Clin Pediatr Endocrinol 2000;9:7-17.
Lagrou K, Xhrouet-Heinrichs D, Craen M, Chanoine JP, Malvaux P, Bourguignon JP: Age-related perception of stature, acceptance of therapy, and psychosocial functioning in human growth hormone-treated girls with Turner's syndrome. J Clin Endocrinol Metab 1998;83:1494-1501.
Vik T, Vatten L, Markestad T, Ahksten G, Jacobsen G: Morbidity during the first year of life in small for gestational age infants. Arch Dis Childhood 1996;75:F33-F37.
Hadders-Algra M, Huisjes HJ, Touwen BLC: Preterm or small for gestational age infants. Neurological and behavioural development at the age of 6 years. Eur J Pediatr 1988;147:460-467.
Silverstein JH, Shulman D: Growth hormone for small-for-gestational-age children: short and sweet? J Pediatr 2003;142:91-92.
Bacharach VR: Effects of maternal intelligence, marital status, income, and home environment on cognitive development of low birth weight Infants. J Pediatr Psychol 1998;23:197-205.
Niklasson A, Ericson A, Fryer JG, Karlberg J, Lawrence C, Karlberg: An update of the Swedish references standards for weight, length and head circumference at birth for given gestational age (1977-1981). Acta Paediatr Scand 1991;80:756-762.
Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA: Cross-sectional stature and weight reference curves for the UK, 1990. Arch Dis Child 1995;73:17-24.
Tanner JM, Whitehouse RH, Takaishi M: Standards from birth to maturity for height, weight, height velocity and weight velocity: British children 1965. Arch Dis Child 1966;41:454-471, 613-635.
Gilmour J, Skuse D: Short stature - the role of intelligence in psychosocial adjustment. Arch Dis Child 1996;75:25-31.
Stathis SL, O'Callaghan MJ, Williams GM, Najman JM, Andersen MJ, Bor W: Behavioral and cognitive associations of short stature at 5 years. J Paediatr Child Health 1999;35:562-567.
Huisman J, Slijper FME, Sinnema G, Akkerhuis GW, Brugman-Boezeman A, Feenstra J, Den Hartog L, Heuvel F: Psychosocial effects of two years of human growth hormone treatment in Turner Syndrome. Horm Res 1993;39:56-59.
Siegel PT, Clopper R, Stabler B: Psychological impact of significantly short stature. Acta Paediatr Scand 1991;377:14-18.
Siegel PT: Psychological adjustment of short children and normal controls; in Stabler B, Underwood LE (eds): Growth, Stature and Adaptation. An international symposium on the behavioral, social, and cognitive aspects of growth delay. Chapel Hill, University of North Carolina, 1994, pp 123-134.
Sandberg DE, Colsman M, Voss LD: Short stature and quality of life: A review of assumptions and evidence; in Pescovitz OH, Eugster E (eds): Pediatric Endocrinology: Mechanisms, Manifestations, and Management. Philadelphia, Lippincot, Williams and Wilkins, 2004, pp 191-202.
Downie AB, Mulligan J: Psychological response to growth hormone treatment in short normal children. Arch Dis Childhood 1996;75:32-35.
Pilpel D, Leiberman E, Zadik Z, Carel CA: Effect of growth hormone treatment on quality of life of short stature children. Horm Res 1995;44:1-5.
Gordon M, Crouthamel C, Post EM, Richman RA: Psychosocial aspects of constitutional short stature: social competence, behavior problems, self-esteem, and family functioning. J Pediatr 1982;101:477-480.
Lee PA, Kendig JW, Kerrigan JR: Persistent short stature, other potential outcomes, and the effect of growth hormone treatment in children who are born small for gestational age. Pediatrics 2003;112:150-162.
Stabler B, Clopper RR, Siegel PT: Academic achievement and psychological adjustment in short children. Develop Behav Pediatrics 1994;15:1-6.
van der Reijden-Lakeman I, Slijper FME, van Dongen-Melman JEWM, de Waal WJ, Verhulst FC: Self-concept before and after two years of growth hormone treatment in intrauterine growth-retarded children. Horm Res 1996;46:88-94.
Downie AB: Are short normal children at a disadvantage? The Wessex growth study. BMJ 1997;314:97-100.
Sandberg DE: Short stature: intellectual and behavioral aspects; in Lifshitz F (ed): Pediatric Endocrinology, ed 3. New York, Marcel Dekker, 1996, pp 149-162.
Kranzler JH: Is short stature a handicap? A comparison of the psychosocial functioning of referred and nonreferred children with normal short stature . J Pediatr 2000;136:96-102.
Stabler B, Siegel PT, Clopper RR, Stoppani CE, Compton PG, Underwood LE: Behavior change after growth hormone treatment of children with short stature. J Pediatr 1998;133:366-373.
Steinhausen HC, Dorr HG, Malin Z: Behavioral evaluation of GH treatment in short statured children and adolescents: Findings from a pilot study. J Endocrinol Invest 2002;25:351-356.
van der Reijden-Lakeman IEA, de Sonneville LMJ, Swaab-Barneveld HJT, Slijper FME, Verhulst FC: Evaluation of attention before and after two years of growth hormone treatment in intrauterine growth-retarded children. J Clin Experim Neuropsychol 1997;19:101-118.
van Pareren YK, Duivenvoorden HJ, Slijper FSM, Koot, HM, Hokken-Koelega ACS: Intelligence and psychosocial functioning during long-term growth hormone therapy in children born small for gestational age. J Clin Endocrinol Metab;2004;89:5295-5302.
