Adrenarche ,pubertal development ,age at menarche and final height of full-term ,born small for gestational age (SGA) girls

Abstract

Children born small for gestational age (SGA) may present advanced bone maturation in childhood and reduced final height. The objectives of the study were to evaluate adrenarche ,pubertal development ,ageat menarche and final height in full-term born-SGA girls. Twenty-four girls (12 born-SGA and 12 matched controls) were evaluated at 6-7.5 years of age for clinical signs of puberty and dehydroepiandrosteronesulfate (DHEAS) levels ,as a marker of adrenarche. Thirty-eight girls (19 born-SGA and 19 matched controls) were evaluated at 17.5-18.5 years of age to assess final height ,sexual maturation and age atmenarche. SGA girls had a mean final height (160.1 cm vs 165.8 cm ,p < 0.01) and mean weight (52.1 kg vs 56.5 kg ,p < 0.05) significantly lower than controls. Controls had a mean finalheight significantly higher than their mean target height. Sexual maturation was at stage 5 of Tanner's staging in SGA girls and control subjects. SGA girls had a slightly anticipated puberty (9.9 vs 10.4years for initial breast development) and a lower age at menarche (11.9 vs 12.3 years). At 6-7.5 years of age ,SGA females and controls did not show any difference for clinical signs of puberty; however,DHEAS levels (0.75 + 0.18μg/ml vs 0.57 + 0.22μg/ml ,p < 0.05) were significantly higher in SGA girls than in control subjects.We concluded that full-term born-SGA females have impairedfinal height and weight in adolescence but substantially normal sexual maturation and age at menarche. Increased DHEAS levels before puberty in born-SGA girls may predispose to increased bone maturationin childhood with a reduced final height. In our population a progressive increment in final stature is evident.