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Impact of being born small for gestational age on onset and progression of puberty

https://doi.org/10.1016/j.beem.2008.02.003Get rights and content

Children born small for gestational age (SGA) are at higher risk for perinatal morbidity, mortality and chronic diseases in later life. There is increasing evidence for a link between prenatal growth and pubertal development, but studies concerning the timing, duration and progression of puberty in these children are scarce and the results are difficult to compare due to the various methodologies employed. Most boys born SGA have normal pubertal timing, but often attain an adult height below the target height. In girls, most studies document a relationship between intra-uterine growth retardation and earlier pubertal development or normal timing but with rapid progression. This chapter will discuss the factors that could influence pubertal development in children born SGA and the information reported to date.

Section snippets

Animal studies

In animals, as in humans, the onset of puberty occurs though interactions between the neuroendocrine and reproductive axes. Results of animal studies indicate that postnatal reproductive ability may be largely determined by appropriate development of the hypothalamic–pituitary–gonadal axis during fetal life.19

It is well established that malnutrition during critical periods in early life has implications for further development.20, 21, 22 Studies evaluating puberty in animals have shown that

Onset and development of puberty

Variations in pubertal timing and progression in children born SGA, as in the rest of the population, are likely to be related to many factors, including ethnicity, genetic background, nutrition and other unknown factors. Epidemiological studies have been performed in different populations from Europe with emphasis on the height attained after puberty in girls and boys born SGA.

In a Swedish follow-up study of singleton pregnancies from birth until 16 years of age, prematurely born children [SGA

Boys

The majority of studies exploring the association between low birth weight (LBW) and the pituitary–gonadal axis have focused on female reproductive function. Information on the influence of fetal growth on male gonadal function is remarkably scarce, and most studies have focused on the relationship between LBW and testis dysgenesis syndrome that is hypothesized to have a fetal origin.36, 37 An adverse effect of toxic or environmental agents (such as oestrogens) on the developing fetal

Summary

Puberty is one of the most important milestones in life. It not only represents the step into maturity, but also involves important body and physiological changes. Restricted prenatal growth may be followed by a permanent resetting of endocrine axes that co-determine pubertal development.

Some animal studies have correlated IUGR and changes in pubertal timing. In addition, a number of human studies have demonstrated a secular trend in the onset of puberty towards earlier pubertal development

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