Health-related quality of life and problem behaviour after GH cessation in adults born SGA: a 12-year follow-up study.

ABSTRACT

CONTEXT Long-term data regarding HRQoL and problem behaviour in adults born SGA who were treated with GH during childhood are lacking. OBJECTIVE: To investigate longitudinal changes in HRQoL and problem behaviour in adults born SGA during 12 years after cessation of childhood GH-treatment (SGA-GH), and compare these with 3 control groups at age around 30 years. PARTICIPANTS: 176 SGA-GH adults and 3 untreated age-matched control groups 50 born SGA with short stature (SGA-S), 77 born SGA with spontaneous catch-up growth to normal height (SGA-CU) and 99 born appropriate-for-gestational-age with normal height (AGA). MAIN OUTCOME MEASURES: HRQoL and problem behavior were assessed using TNO-AZL Adults Quality of Life questionnaire (TAAQoL) and Adolescent Behavior Check List (ABCL) at 6 months, 2, 5 and 12 years after GH-cessation. Data at 12-years after GH-cessation were compared with 3 control groups. RESULTS: During 12 years after GH-cessation, HRQoL remained similar on 9 subscales in SGA-GH adults, but decreased on 3 subscales (gross motor functioning, pain, sleep). Externalizing problem behaviour decreased significantly and internalizing problem behaviour tended to decrease. SGA-GH and SGA-S adults had similar HRQoL and problem behaviour. SGA-GH adults had, compared to AGA adults, similar HRQoL on 7 subscales, lower HRQoL on 5 subscales and more internalizing and externalizing problem behaviour. All SGA adults had lower HRQoL and more internalizing problem behaviour than AGA adults. Adult height associated negatively with externalizing problem behaviour, but the influence was small. CONCLUSIONS: During 12 years after GH-cessation, HRQoL remained mostly similar and problem behaviour decreased in SGA-GH adults. SGA-GH and SGA-S adults had similar HRQoL and problem behaviour. All SGA adults had lower HRQoL and more internalizing problem behaviour than AGA adults.