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Pfizer has announced in the June 2003 issue of Pediatrics, the official journal of the American Academy of Pediatrics, the publication of an international consensus statement on the Deficiency and management of persistent short stature in children born small for gestational age (SGA) who do not exhibit catch-up growth by age two.
According to the consensus statement, SGA is defined as babies with a birth weight or length or both at least 2 standard deviations (SD) below the mean for their gestational age, which translates to below the third percentile on most growth charts. In full-term babies, this roughly estimates to less than 5 lbs 6 ounces and/or 18 inches long. Accurate gestational dating and measurement of birth weight and length are important to identify children with the condition.
The consensus statement endorses the use of growth hormone therapy to normalize height of children born SGA who do not manifest catch-up growth by age two. There is long-term experience with growth hormone doses ranging from 0.24 to 0.48 mg/kg/wk (milligrams per kilogram per week). However the higher dose is more effective in terms of short-term growth, which is why the consensus statement suggests a starting dose at 0.48 mg/kg/wk to achieve rapid catch-up growth.
In the United States, an estimated 91,000 infants are born SGA every year. While the majority of these children manifest spontaneous catch-up growth by age two, approximately 10 percent do not. It is this group of SGA children that are considered to have persistent short stature, or SGA without catch-up growth. These children are at risk for short stature throughout their lives and therefore should be referred to a pediatric endocrinologist or pediatric growth specialist for evaluation.
The consensus statement was issued by a 13-member international advisory board of leading endocrinologists and pediatric growth specialist through an unrestricted educational grant from Pharmacia Corporation, a wholly-owned subsidiary of Pfizer.
In July 2001, the Food and Drug Administration approved Genotropin ® (somatropin (rDNA origin)] for injection), manufactured by Pharmacia Corporation for the long-term growth failure of children who were born SGA, at a recommended dosage of 0.48 mg/kg body weight/week.
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