Precocious pubarche is associated with SGA, prematurity, weight gain, and obesity.
BACKGROUND
Perinatal stress is thought to underlie the Barker sequelae of low birth weight, of which precocious pubarche may be a manifestation.


OBJECTIVE
To explore whether prematurity as well as smallness for gestational age (SGA) predisposes to precocious pubarche, and the potential role of excess weight gain during childhood.


METHODS
Retrospective chart review of 89 children (79 girls) with precocious pubarche.


RESULTS
Sixty five per cent were overweight/obese at diagnosis, compared with 19-24% of Australian children. Thirty five per cent had a history of SGA and 24% of prematurity. Weight SDS increased from birth to diagnosis in 91% of children. The mean change in weight SDS from birth to diagnosis was greater in those who were SGA (2.8, 95% CI 2.2 to 3.4) versus AGA (1.7, 95% CI 1.3 to 2.2), with no difference in the incidence of overweight/obesity. The latter was lower among children born premature (40% versus 72% term) but was associated with a mean increase in weight of 1.3 SDS during childhood. Nine out of ten girls and boys with precocious pubarche had at least one of the three risk factors studied.


CONCLUSIONS
Both prematurity and SGA were associated with precocious pubarche, as was overweight/obesity, irrespective of size or gestation at birth. Excess weight gain in childhood may predispose to precocious pubarche in susceptible individuals.
Neville
K A
KA
Department of Endocrinology, Sydney Children's Hospital, High St, Randwick, NSW 2031, Australia. nevillek@sesahs.nsw.gov.au
Walker
J L
JL
D016009:Chi-Square Distribution; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D008297:Male; D009517:New South Wales; D009765:Obesity / Q000209:etiology*; D011629:Puberty, Precocious / Q000209:etiology*; D012189:Retrospective Studies; D015430:Weight Gain
J Epidemiol Community Health. 1992 Jun;46(3):184-6
1645067
Pediatr Res. 1996 Aug;40(2):319-24
8827784
J Paediatr Child Health. 1996 Dec;32(6):512-8
9007782
J Clin Endocrinol Metab. 1997 Feb;82(2):402-6
9024226
Pediatr Res. 1997 Mar;41(3):440-2
9078549
J Clin Endocrinol Metab. 1997 Jul;82(7):2283-8
9215308
BMJ. 1997 Aug 16;315(7105):396-400
9277603
J Clin Endocrinol Metab. 1998 Oct;83(10):3558-62
9768664
J Clin Endocrinol Metab. 1999 Aug;84(8):2691-5
10443661
J Clin Endocrinol Metab. 1999 Nov;84(11):3936-44
10566631
Acta Paediatr Suppl. 1999 Dec;88(433):67-72
10626548
BMJ. 2000 Apr 8;320(7240):967-71
10753147
BMJ. 2000 May 6;320(7244):1240-3
10797032
Endocr Rev. 2000 Dec;21(6):671-96
11133068
BMJ. 2001 Apr 21;322(7292):949-53
11312225
Diabetes Care. 2001 Apr;24(4):683-9
11315831
Aust N Z J Public Health. 2001 Apr;25(2):162-9
11357914
Fertil Steril. 2001 Oct;76(4):730-5
11591406
J Pediatr. 2004 Jan;144(1):23-9
14722514
Eur J Pediatr. 2004 Feb;163(2):89-93
14689304
J Clin Endocrinol Metab. 1968 Nov;28(11):1525-33
4235151
J Clin Endocrinol Metab. 1976 Dec;43(6):1219-25
137247
Am J Clin Nutr. 1979 Mar;32(3):607-29
420153
Am J Clin Nutr. 1989 Apr;49(4):608-11
2648795
Lancet. 1989 Sep 9;2(8663):577-80
2570282
J Clin Endocrinol Metab. 1989 Dec;69(6):1133-6
2531155
Eur J Clin Nutr. 1991 Jan;45(1):13-21
1855495
Aust N Z J Obstet Gynaecol. 1991 Feb;31(1):17-9
1872765
Lancet. 1993 Apr 10;341(8850):938-41
8096277
J Clin Endocrinol Metab. 1993 Jun;76(6):1599-603
8501168
Diabetologia. 1994 Feb;37(2):150-4
8163048
Aust N Z J Obstet Gynaecol. 1994 Feb;34(1):39-50
8053875
J Clin Endocrinol Metab. 1993 Nov;77(5):1174-9
8077309
BMJ. 1995 Jul 15;311(6998):171-4
7613432
Lancet. 1996 Nov 9;348(9037):1269-73
8909379