title: Hypergonadotrophinaemia with reduced uterine and ovarian size in women born small-for-gestational-age.
abstract: BACKGROUND
  Fetal growth restraint has been associated with FSH hypersecretion in early infancy and in early post-menarche, and with reduced uterine and ovarian size in adolescence. It is unknown whether these reproductive anomalies persist, respectively, into late infancy and into the reproductive age range.
  
  
  METHODS
  We report follow-up findings in two age groups of girls. A cohort of infants [n=26; n=10 born appropriate-for-gestational-age (AGA) and n=16 born small-for-gestational-age (SGA)], who had been studied at the age of approximately 4 months, was assessed again at the age of 12 months. A cohort of teenagers (n=28), who had been studied at the age of approximately 14 years, was assessed again at the age of approximately 18 years; this group was complemented by a transversal cohort of similar age (n=19) for a total of 47 young women (n=27 AGA; n=20 SGA). In infants, only serum FSH was measured; adolescents underwent endocrine-metabolic screening, ultrasound assessment of uterine-ovarian size, and evaluation of body composition by dual X-ray absorptiometry.
  
  
  RESULTS
  Serum FSH levels were higher in SGA than AGA infant girls at 4 and 12 months, and higher in SGA than AGA adolescents at 14 and 18 years (all P<0.01). Longitudinal ultrasound assessments disclosed a late-adolescent increment of uterine size that was less obvious in SGA than AGA girls. In contrast, ovarian volume remained stable in both subgroups. Compilation of longitudinal and transversal results at 18 years of age corroborated the persistent reduction in the uterine size of SGA girls (by approximately 20%; P<0.005) and in their ovarian volume (by approximately 40%; P<0.0001); moreover, SGA girls displayed not only a persistent elevation of FSH (by approximately 50%; P<0.001), but also a rise of LH and fasting insulin, as well as an excess of abdominal fat (all P<0.01).
  
  
  CONCLUSIONS
  The gynaecology of young women born SGA was found to be characterized by hypergonadotrophinaemia and by a reduced uterine and ovarian size.
authors.affiliation: Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Spain. libanez@hsjdbcn.org
authors.forename: Lourdes
authors.initials: L
authors.lastname: Ibáñez
authors.forename: Neus
authors.initials: N
authors.lastname: Potau
authors.forename: Goya
authors.initials: G
authors.lastname: Enriquez
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Marcos
authors.forename: Francis
authors.initials: F
authors.lastname: de Zegher
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D043373:Follicle Stimulating Hormone, Human / Q000097:blood*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008137:Longitudinal Studies; D007986:Luteinizing Hormone / Q000097:blood*; D010053:Ovary / Q000033:anatomy & histology / Q000254:growth & development*; D014599:Uterus / Q000033:anatomy & histology / Q000254:growth & development*
chemical_list: D043373:Follicle Stimulating Hormone, Human; D007986:Luteinizing Hormone