Eligibility of children born small for gestational age for treatment with growth hormone

SGA: small for gestational age; SD: standard deviation; rhGH: recombinant human growth hormone.
* SGA is defined as weight and/or length at birth <-2 SD for gestational age.
¶ In the United States, rhGH is approved for children who were born SGA and whose height is 2 SD or more below the mean for age and sex at 2 years of age (ie, height <-2 SD). In Europe, rhGH is approved in short SGA children whose height is <-2.5 SD at 4 years of age, with low height velocity and low predicted height.
Δ Short stature is defined as height <-2 SD for chronologic age. Approximately 10% of children born SGA are within this range at age 2 to 4 years.
◊ Normal height is defined as height >-2 SD for age; approximately 90% of children born SGA are within this normal range at age 2 to 4 years.
§ Pathologic causes of short stature may be metabolic (eg, underlying systemic disease), endocrinologic (eg, growth hormone deficiency), or genetic (eg, Turner syndrome). Other children may have normal variants of growth, including familial short stature and constitutional delay of growth and puberty. Refer to UpToDate content on diagnostic approach to short stature.