Growth hormone therapy for non-growth hormone-deficient children with short stature

A summary of the majority of the available uncontrolled studies of 322 children with idiopathic short stature treated with growth hormone showed that the final height attainment over predicted adult height was only +2.85 cm (+0.49 SD score). Furthermore, a summary of seven studies reported that the spontaneous outcome in children with untreated idiopathic short stature was more than +1 SD score in final height compared to height at presentation; patients with delayed puberty spontaneously gained more than +2 SD score as adults. Recent reevaluations have concluded that short stature is not associated with clinically significant psychologic morbidity, and the psychologic outcome in response to growth hormone treatment of the short normal child showed no discernable difference in psychologic benefit, despite a difference in height gained. A recent editorial has strongly advised against the expanded use of growth hormone in the normal short child.