Children, Growth Hormone, & Possible Risk Later
Parents should discuss pros and cons of treatment with their child's doctor, researchers suggest
Participants were, on average, 11 years old when they started growth hormone treatment and took it for about four years. Comparison data for stroke incidence in a comparable time period were obtained from population-based registries in France and the United Kingdom.
During the follow-up time period, 11 of the participants had a stroke; eight of the strokes were hemorrhagic. The strokes occurred at an average age of 24, and four people died as a result of the stroke.
That compared to three to seven expected strokes in total in the general populations, with two of those being hemorrhagic strokes.
Hemorrhagic stroke occurs when a weakened vessel ruptures and bleeds into the surrounding brain tissue, according to the American Heart Association.
Despite the large size and scope of the study, the researchers said there are notable unresolved questions. Scientists still do not fully understand why or how growth hormone may affect stroke risk, or what characteristics of a child or adolescent might increase his or her individual risk. And while the study showed an association between use of growth hormone and an increased stroke risk, it did not establish a cause-and-effect relationship.
Researchers still have no idea what the effect of taking growth hormone in childhood might have over longer periods of time.
"It's an additional elephant in the room, what happens to these individuals when they experience aging," said Ichord. "Who knows what the same population might be like in their 40s, 50s or 60s?"
Ichord said physicians treating children need to evaluate potential lifelong implications of treatment. "We in pediatrics need to be humble about things we do to children when they are young and be prepared to look at the long-term outcomes of treatments we prescribe," she noted.
Ichord encouraged people who are taking or have taken growth hormone therapy to be informed about how to help prevent strokes, how to identify early signs of a stroke and the importance of seeking treatment quickly.