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Intrauterine growth retardation and puberty in girls
J J Voordouw1, M M van Weissenbruch, H A Delemarre-van de Waal
1Research Institute for Endocrinology, Reproduction and Metabolism, Department of Pediatrics of the VU-Medical Center, Amsterdam, The Netherlands. jj.voordouw@Vumc.nl
Insights
Intrauterine growth retardation (IUGR) may lead to earlier puberty in girls, but it
Area of Science:
- Reproductive Endocrinology
- Developmental Biology
- Pediatric Endocrinology
Background:
- Intrauterine growth retardation (IUGR) is associated with various health issues, including potential alterations in female pubertal development.
- Some studies suggest IUGR may contribute to earlier and accelerated puberty, alongside conditions like polycystic ovary syndrome and short stature.
- The precise mechanisms linking IUGR to pubertal timing and progression remain unclear, with ongoing debate on contributing factors.
Purpose of the Study:
- To explore the relationship between intrauterine growth retardation (IUGR) and the timing and progression of female puberty.
- To investigate potential mechanisms, such as hormonal regulation and growth patterns, underlying pubertal changes in IUGR-affected individuals.
- To clarify whether observed earlier puberty in IUGR girls represents an earlier onset or simply faster progression.
Main Methods:
- Review of existing literature examining the association between IUGR and female pubertal development markers, including age at menarche.
- Analysis of hypotheses concerning the initiation of puberty and the long-term effects of IUGR, drawing parallels between them.
- Consideration of twin studies with discordant birth weights as a potential avenue for further research into nature vs. nurture influences.
Main Results:
- Evidence suggests a link between IUGR and altered pubertal trajectories in females, though findings are not universal across all studies.
- Concomitant disorders like polycystic ovary syndrome and short stature are frequently observed alongside these pubertal changes.
- The exact role of IUGR and the specific mechanisms driving puberty initiation in this context require further elucidation.
Conclusions:
- The precise impact of IUGR on female pubertal timing and progression requires further investigation, particularly regarding underlying mechanisms.
- The interplay between IUGR, hormonal regulation (e.g., gonadotropin-releasing hormone pulsatility), and pubertal onset warrants continued research.
- Future studies, potentially utilizing twin models, could help disentangle the genetic and environmental factors influencing these associations.
Abstract:
Some, albeit not all studies on the relationship between intrauterine growth retardation (IUGR) and female pubertal development have found an earlier and rapidly progressing puberty as well as concomitant disorders of related functional systems such as polycystic ovary syndrome and short stature. These pubertal changes are part of a growing list of IUGR-related diseases, which includes non-insulin dependent diabetes mellitus and coronary heart disease. A pulsatile release of gonadotropin releasing hormone is thought to be a conditio-sinne-qua-non for the initiation of puberty. In the absence of prospective studies on gonadotropin releasing hormone pulse patterns in IUGR-children other markers of pubertal development such as age at menarche have been deployed. From these studies it is not clear, however, whether the findings of an earlier onset of puberty in IUGR-girls merely reflect a more rapid progression of puberty. Both the role for IUGR and the mechanisms behind the onset of puberty are still elusive. Assuming a connection between IUGR and pubertal development, parallels can be drawn between hypotheses on the longterm consequences of IUGR and hypotheses on the initiation of puberty. For example, the somatometer concept proposes a role for fat mass in the initiation of puberty, which is compatible with the hypothesis on non-skeletal catch-up growth after IUGR. The debate on the origins of puberty and the role of IUGR mainly focuses on nature and nurture. Judgmentally, studies in mono- and dizygotic twins discordant for birth weight may be of particular help.