Health-related Quality of Life and Problem Behavior After GH Cessation in Adults Born Small for Gestational Age: A 12-Year Follow-up Study

Context Long-term data regarding health-related quality of life (HRQoL) and problem behavior in adults born small for gestational age (SGA) who were treated with GH during childhood are lacking.Objective To investigate longitudinal changes in HRQoL and problem behavior 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 One hundred seventy-six 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 the TNO-AZL Adults Quality of Life questionnaire and Adolescent Behavior Check List at 6 months and 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 behavior decreased significantly, and internalizing problem behavior tended to decrease. SGA-GH and SGA-S adults had similar HRQoL and problem behavior. SGA-GH adults had, compared to AGA adults, similar HRQoL on 7 subscales, lower HRQoL on 5 subscales, and more internalizing and externalizing problem behavior. All SGA adults had lower HRQoL and more internalizing problem behavior than AGA adults. Adult height associated negatively with externalizing problem behavior, but the influence was small.Conclusion During 12 years after GH cessation, HRQoL remained mostly similar and problem behavior decreased in SGA-GH adults. SGA-GH and SGA-S adults had similar HRQoL and problem behavior. All SGA adults had lower HRQoL and more internalizing problem behavior than AGA adults.