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Puberty and prenatal growth

Lourdes Ibáñez1, Francis de Zegher

  • 1Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Passeig de Sant Joan de Déu 2, 08950 Esplugues, Barcelona, Spain. libanez@hsjdbcn.org

Molecular and Cellular Endocrinology
|June 8, 2006
PubMed

Insights

Children born small-for-gestational-age (SGA) experience altered puberty. Insulin resistance may drive early puberty in SGA girls, suggesting insulin sensitization as a potential intervention.

Area of Science:

  • Pediatric Endocrinology
  • Reproductive Health
  • Developmental Biology

Background:

  • Prenatal growth restriction, indicated by being born small-for-gestational-age (SGA), is increasingly linked to pubertal development.
  • Children born SGA exhibit distinct pubertal trajectories compared to their peers.

Purpose of the Study:

  • To review pubertal characteristics in children born small-for-gestational-age (SGA).
  • To explore potential mechanisms, such as insulin resistance, linking SGA status to altered pubertal timing.
  • To discuss therapeutic implications for managing pubertal issues in SGA individuals.

Main Methods:

  • Review of existing literature on pubertal development in children born small-for-gestational-age (SGA).
  • Analysis of hormonal profiles (FSH, inhibin B) and physical characteristics (testicular volume, genitalia size) in SGA populations.
  • Examination of the impact of insulin-sensitizing therapy on ovulation rates in SGA adolescents.

Main Results:

  • Boys born SGA may have elevated FSH, low inhibin B, and smaller testicular volume during adolescence.
  • Girls born SGA tend to experience earlier pubertal onset and menarche (by 5-10 months), with potential associations with higher FSH and smaller internal genitalia.
  • SGA adolescents exhibit reduced ovulation rates, which can be improved with insulin-sensitizing therapy.
  • Precocious pubarche in SGA girls is associated with advanced menarche, potentially mediated by insulin resistance.

Conclusions:

  • Prenatal growth restriction impacts pubertal development in both boys and girls born SGA.
  • Insulin resistance is a likely mechanism connecting the post-SGA state to early menarche in girls.
  • Insulin sensitization presents a promising therapeutic strategy to prevent early menarche and growth arrest in SGA girls.

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