title: Pubertal development in children born small for gestational age.
abstract: Reduced fetal growth appears to be associated with precocious adrenarche, early puberty and polycystic ovary syndrome with subsequent fertility problems. We investigated pubertal development and DHEAS levels in children born small for gestational age (SGA) and children born appropriate for gestational age (AGA). Physical examination was carried out twice. Mean age (+/-SD) at the first visit: SGA group, 9.1+/-1.1 yr; AGA group, 9.0+/-1.1 yr. AT FOLLOW-UP: SGA group, 11.6+/-1.0 yr; AGA group, 11.6 +/-1.1 yr. Pubertal stages of the children were assessed. Pubic hair was recorded as a measure of androgenization. Chronological age (CA) was expressed as a percentage of the age corresponding to the pubertal stage (CA/pubertal age [PA] x 100%). Estradiol, testosterone and dehydroepiandrosterone sulfate (DHEAS) were measured in all children. FIRST VISIT: All children were prepubertal without signs of pubarche. DHEAS concentrations were higher in SGA children than in AGA children (p = 0.004).
  
  
  RESULTS
  Twenty SGA children and 15 AGA children were pubertal. CA/PA x 100% was lower in SGA girls than in AGA girls (p = 0.004). Since 2.5 years earlier all girls had been prepubertal, this means a more rapid progression in the SGA girls. CA/PA x 100% was similar in SGA and AGA boys (p = 0.1). DHEAS levels tended to be higher in SGA children than in AGA children (p = 0.06). These data support that a low birth weight may have long-lasting effects on pubertal development, as observed in a more rapid progression in SGA girls. In prepubertal SGA children, an exaggerated adrenarche is observed compared to AGA children, which tended to persist through puberty.
authors.affiliation: Department of Pediatrics, Research Institute for Endocrinology, Reproduction and Metabolism, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Margreet A
authors.initials: MA
authors.lastname: Veening
authors.forename: Mirjam M
authors.initials: MM
authors.lastname: van Weissenbruch
authors.forename: John J
authors.initials: JJ
authors.lastname: Roord
authors.forename: Henriette A
authors.initials: HA
authors.lastname: de Delemarre-van Waal
mesh_terms: D000886:Anthropometry; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008297:Male; D012727:Sex Characteristics; D012741:Sexual Maturation / Q000502:physiology*; D013739:Testosterone / Q000097:blood
chemical_list: D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D005640:Follicle Stimulating Hormone