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Research Article: Three decades of recombinant human growth hormone research in children born small for gestational age: a bibliometric analysis (1996–2025)

Date Published: 2026-09-09

Abstract:
Recombinant human growth hormone (rhGH) has been a standard therapy for short children born small for gestational age (SGA) since 2001 (FDA) and 2003 (EMA), yet no bibliometric analysis has mapped this field's intellectual structure. Publications were retrieved from four databases, Lens.org ( n =?1,184), OpenAlex ( n =?1,343), Web of Science Core Collection ( n =?1,121), and Scopus ( n =?1,589), yielding 793 unique records after DOI-based merging, therapeutic-relevance filtering, conference-abstract removal, and expert-led relevance auditing, restricted to the 30 complete calendar years 1996–2025. Analyses included publication trends, Bradford's and Lotka's Laws, co-authorship and keyword co-occurrence networks, geographic mapping, citation metrics, open access (OA) trends, keyword trend analysis across three regulatory phases, and transformer-based topic modeling (BERTopic). The field showed three phases temporally aligned with regulatory milestones, stabilizing at a compound annual growth rate (CAGR) of 6.3% (2011–2025). Hormone Research in Paediatrics ( n =?107) and the Journal of Clinical Endocrinology & Metabolism ( n =?89) were the leading sources. Hokken-Koelega ACS was the most prolific author ( n =?81, combining name variants). The United States ( n =?115), the Netherlands ( n =?111), and Germany ( n =?95) led in output across 67 countries. The corpus-level h-index was 66, with 19,415 total citations and a Gini coefficient of 0.69 indicating substantial citation inequality. An unadjusted comparison of citations by open-access status was null ( p =?0.86); however, after adjusting for citation age and document type, open-access articles received 2.2-fold more citations than closed-access articles (incidence-rate ratio 2.20, 95% CI 1.84–2.63), an association that attenuated but persisted within journals (1.45). BERTopic identified 7 research themes from 771 abstracts, showing a temporal shift from basic efficacy studies toward molecular and genetic diagnostics (GH–IGF-I axis, Silver–Russell syndrome, genetic short stature) and patient-centered outcomes. Keyword trend analysis across three regulatory phases identified 8 terminological shifts that remained significant after false-discovery-rate correction, including a decline in “IUGR” usage ( ? 2 =?66.9, p <?0.001) and a rise in observational/registry studies ( ? 2 =?37.6, p <?0.001). The rhGH–SGA literature shows a maturing research landscape with increasing thematic diversification from efficacy studies toward molecular and genetic diagnostics and patient-centered outcomes. Keyword trend analysis reveals measurable shifts in terminology, study methodology, and patient populations, identifying gaps and emerging directions that can inform future trial design and funding priorities.

Introduction:
Recombinant human growth hormone (rhGH) has been a standard therapy for short children born small for gestational age (SGA) since 2001 (FDA) and 2003 (EMA), yet no bibliometric analysis has mapped this field's intellectual structure.

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