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Adrenarche and fetal growth

I Francois¹, F de Zegher

¹Department of Paediatrics, University of Leuven, Belgium.

Pediatric Research

|March 1, 1997

Summary

Children small for gestational age (SGA) show higher dehydroepiandrosterone sulfate (DHEAS) levels than appropriate for gestational age (AGA) siblings when birth weight discordance is minimal. This suggests a link between fetal growth and adrenarche.

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Area of Science:

Endocrinology
Pediatric Endocrinology
Reproductive Endocrinology

Background:

Dehydroepiandrosterone sulfate (DHEAS) is a key hormone secreted by the fetal adrenal gland, indicating adrenarche and reflecting adult hormonal status.
The precise regulatory mechanisms governing DHEAS secretion remain largely unelucidated.
Prenatal factors, such as fetal growth, may influence postnatal DHEAS levels.

Purpose of the Study:

To investigate the potential relationship between fetal growth and serum DHEAS concentrations in children.
To explore whether birth weight discordance within multiple gestations impacts DHEAS levels during childhood.

Main Methods:

Serum DHEAS levels were measured in 13 pairs of discordant siblings from multiple pregnancies (twins, triplets, quadruplets).
Siblings were categorized at birth as small for gestational age (SGA) or appropriate for gestational age (AGA).
Weight discordance between siblings at birth and at the time of sampling was assessed.

Main Results:

In sibling pairs with similar weight at sampling (≤1 SD difference), SGA children exhibited significantly higher serum DHEAS concentrations (median 2-fold increase) compared to their AGA counterparts.
Conversely, in pairs with greater weight discordance (>2 SD difference), SGA children had lower DHEAS levels than AGA siblings.
These findings were observed while accounting for both prenatal and postnatal weight changes.

Conclusions:

A significant association exists between fetal growth (as indicated by SGA status) and adrenarche, mediated by DHEAS levels.
This relationship highlights the concept of early endocrine programming, extending its influence to the development of adrenarche.
The degree of weight discordance plays a crucial role in modulating the observed link between fetal growth and DHEAS secretion.

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