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Timing of puberty and fetal growth
1Department of Paediatrics, Subdivision of Endocrinology, Sophia Children's Hospital, Erasmus University Medical Center, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
Insights
Children born small for gestational age (SGA) face higher risks for chronic diseases. While some studies link SGA to early puberty and hormonal issues, evidence remains inconclusive, requiring further research.
Area of Science:
- Pediatric endocrinology
- Reproductive health
- Developmental biology
Background:
- Children born small for gestational age (SGA) exhibit increased risks for perinatal complications and later-life chronic diseases, including hypertension, type 2 diabetes, and cardiovascular disease.
- Intrauterine growth retardation may impact the programming of endocrine axes during critical fetal development periods.
- Previous studies suggested associations between reduced fetal growth and conditions like precocious adrenarche, hyperandrogenism, and PCOS in adolescent girls, though findings are conflicting.
Purpose of the Study:
- To investigate the long-term health consequences for children born small for gestational age (SGA).
- To examine the potential impact of intrauterine growth retardation on endocrine development and pubertal timing.
- To clarify conflicting findings regarding SGA, puberty, and hormonal imbalances.
Main Methods:
- Review of existing studies on children born small for gestational age (SGA).
- Analysis of data on endocrine axes programming and fetal development.
- Comparison of pubertal timing and hormonal profiles between SGA children and controls.
Main Results:
- Conflicting evidence exists regarding SGA and the onset of precocious puberty or hyperandrogenism.
- Some studies indicate a reduced ovarian follicle count in SGA girls, potentially affecting fertility.
- Most research suggests SGA children initiate puberty at a normal, albeit early, age, with comparable menarche timing to controls.
Conclusions:
- Further research is essential to draw definitive conclusions about the long-term health outcomes and pubertal development in SGA children.
- Limited data exists on puberty duration, adult height attainment, peak height velocity, and fertility in this population.
- The potential impact of SGA on endocrine health and reproductive potential warrants continued investigation.
Abstract:
Children born small for gestational age (SGA: birth weight or birth length more than 2 standard deviations below the mean score) are at a higher risk of perinatal morbidity and mortality and of a number of chronic diseases in later life such as hypertension, decreased insulin sensitivity, diabetes mellitus type 2 and an increased risk of cardiovascular disease. The programming of the endocrine axes occurs during critical phases of fetal development and might thus be affected by intrauterine growth retardation. Studies in Northern Spanish adolescent girls have indicated associations between reduced fetal growth and the occurrence of precocious adrenarche, pubarche, hyperandrogenism, polycystic ovary syndrome (PCOS) and hyperinsulinism. These findings have attracted much attention because it might have serious consequences in later life. However, hyperandrogenism and precocious pubarche were not confirmed in a large Dutch study in short children born SGA. Two studies reported a lower number of follicles in the ovaries in girls born SGA, which might have an impact on fertility. Clearly, further studies are required before definite conclusions can be drawn. There are still only limited data concerning the timing of puberty in children born SGA. Most studies indicate that these children start their puberty at a normal age but relatively early within the normal range. Age at menarche seems comparable with controls. Data on duration of puberty, influence of puberty on attainment of adult height, peak height velocity during puberty and fertility are not yet known.