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Minipuberty in Male Full-term Neonates Appropriate and Small for Gestational Age and in Preterm Babies: Data from a

Alessandra Boncompagni1, Elisa Pietrella2, Erica Passini1

  • 1University of Modena and Reggio Emilia, Department of Medical and Surgical Sciences of Mothers, Children and Adults, Neonatal Intensive Care Unit, Modena, Italy

Journal of Clinical Research in Pediatric Endocrinology
|September 26, 2023
PubMed

Insights

Postnatal hypothalamic-pituitary-gonadal (HPG) axis activation, or minipuberty, shows distinct patterns in preterm infants, with higher urinary gonadotropins and testosterone. This early HPG axis function may be crucial for development.

Area of Science:

  • Pediatric Endocrinology
  • Neonatal Physiology
  • Reproductive Medicine

Background:

  • The postnatal activation of the hypothalamic-pituitary-gonadal (HPG) axis, termed "minipuberty," is incompletely understood, particularly concerning variations based on gestational age (GA) and birth weight (BW).
  • Limited longitudinal data exist on the functional significance of minipuberty in relation to sex, GA, and BW.

Purpose of the Study:

  • To longitudinally quantify urinary follicle stimulating hormone (uFSH), luteinizing hormone (uLH), and testosterone (uTs) in male neonates.
  • To compare HPG axis activation patterns in full-term appropriate for gestational age (FT AGA), full-term small for gestational age (FT SGA), and preterm (PT) neonates.
  • To correlate urinary hormone levels with auxological parameters, linear growth, and external genitalia development.

Main Methods:

  • A single-center, longitudinal study involving 46 male neonates.
  • Stratification into three groups: FT AGA (n=23), FT SGA (n=11), and PT (≤33 weeks GA, n=12).
  • Measurement of urinary hormones (uFSH, uLH, uTs) and correlation with growth and genital parameters.

Main Results:

  • Preterm (PT) boys exhibited pulsatile urinary gonadotropins (uGns) with elevated uLH and increasing uTs, alongside earlier testicular descent.
  • Full-term appropriate for gestational age (FT AGA) boys showed superior linear growth during the first 12 months post-term age (PTA).
  • PT infants had higher uGns until 3 months PTA, with significantly higher uLH in the first 90 days and elevated uTs compared to FT AGA. Penile growth correlated significantly with uTs overall.

Conclusions:

  • Postnatal HPG axis activation (minipuberty) differs between term and preterm infants, suggesting an early window for assessing HPG axis function.
  • Gestational age and birth weight significantly influence minipuberty patterns and early development.
  • Further long-term follow-up studies are necessary to elucidate the consequences of GA and BW on HPG axis function.
Abstract

Keywords:
Minipubertygrowthinfantsnewbornprematurityurinary gonadotropins

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