Gestational Age Children Research Articles

IGF1R Gene Alterations in Small for Gestational Age (SGA) Children.

BACKGROUND:Small for gestational age children (SGA) is born on term with BW and or BL of -2.0 standard deviation score (SDS). SGA children have an increased risk of being short, developing DM, and cardiovascular and cerebrovascular disease. Often defects of IGF1R are the cause of SGA. Most frequently affected part of the IGF1R gene is the exon 2.AIM:To investigate whether the exon 2 of the IGF1R gene is affected in the SGA children.PATIENTS AND METHODS:A cohort of 100 SGA children born in term was evaluated for alterations in IG1R gene. Their anthropometric parameters, IGF1 serum concentrations and IGF1 SDS values were analysed. The molecular analysis of IGF1R gene was performed by PCR restriction-site analysis and followed by direct sequencing of conspicuous fragments.RESULTS:Within our cohort, 64 SGA children were with short stature (height SDS -3.25 ± 0.90 SDS), and 36 were with normal height for their age and sex, (H SDS was 0.20 ± 1.1 SDS). None of these children had microcephaly (occipitofrontal circumference -0.70 ± 1.01 SDS vs 0.06 ± 0.56 SDS in SGA children with normal height) or dysmorphic features. The IGF1 serum concentrations and IGF1 SDS values of all children were within normal range. Only one child had lower normal serum IGF1 concentration. No alterations in exon 2 of IGF1R gene were detected.CONCLUSIONS:The genetic analysis of the exon 2 of the IGF1R gene did not detect any gene defects in the analysed patients. The putative genetic defect in those children affects other parts of the IGF1R gene or another gene (s), or yet unidentified factors.

THU-192 - Pregnancy and birth outcomes in a Danish nationwide cohort of women with autoimmune hepatitis and matched population controls

BACKGROUND Many patients with autoimmune hepatitis are women of fertile age. Some concerns of these patients are related to pregnancy. AIM To conduct a nationwide study on risk of miscarriage, birth rate, and birth outcomes in women with autoimmune hepatitis. METHODS From Danish healthcare registries, 1994-2015, we identified 179 births in 103 women with autoimmune hepatitis, 70 of which were first-time singleton births, and 1623 births in 1051 age-matched women (population controls), 662 of which were first-time singleton births. We calculated the risk of miscarriage and the birth rate after autoimmune hepatitis diagnosis in women with autoimmune hepatitis and controls. We used logistic regression to compare the odds of adverse birth outcomes (preterm birth, small for gestational age, congenital malformations and stillbirth) between women with autoimmune hepatitis and controls, adjusting for maternal age and smoking habits. RESULTS The risk of miscarriage was similar in women with autoimmune hepatitis and controls: risk ratio 1.17 (95% confidence interval 0.81-1.68). The first-time birth rate, including singleton and multiple births, per 1000 person-years in women with autoimmune hepatitis was 37 (95% confidence interval 29-46), in controls 32 (95% confidence interval 30-35). Age at first-births was similar in women with autoimmune hepatitis and controls. Women with autoimmune hepatitis had an increased risk of preterm birth (adjusted odds ratio 3.19, 95% confidence interval 1.53-6.64) and small for gestational age babies (adjusted odds ratio = 3.20, 95% confidence interval 0.33-31.29), but not of congenital malformations (adjusted odds ratio = 1.27, 95% confidence interval 0.48-3.34) or stillbirth. Birth outcomes did not differ in autoimmune hepatitis patients on or off immunosuppression, and with or without cirrhosis. CONCLUSIONS In Danish women with autoimmune hepatitis, fertility was unaffected. They had an increased risk of preterm birth and small for gestational age children, but not of congenital malformations or stillbirth.

Paliperidone and pregnancy-an evaluation of the German Embryotox database.

Schizophrenic or schizoaffective disorders often occur in early adulthood and thus affect women of childbearing age. For paliperidone information about reproductive safety is wanting. Therefore, we evaluated data from the German Embryotox pharmacovigilance institute regarding paliperidone therapy during pregnancy. The German Embryotox pharmacovigilance institute offers risk assessment on drug use in pregnancy and documents the outcome of more than 3500 drug-exposed pregnancies per year. In our study, we analyze the outcome of all pregnancies with paliperidone exposure, which have been assessed by our institute between January 2007 and June 2016. Of the 17 prospectively assessed pregnancies, 14 resulted in 15 live-born children (including one pair of twins). None of the infants presented with major congenital malformations. There were two spontaneous abortions at gestational weeks 6 and 11, respectively, and one elective termination due to personal reasons. Sixty-five percent of the pregnant women smoked cigarettes throughout pregnancy, 17% consumed alcohol. Five children were born prematurely (< 37 gestational weeks) and four were small for gestational age, each group including the twins. The results of our study suggest that paliperidone may be administered during pregnancy. The increased rate of prematurity and small for gestational age children can at least partially be explained by other risk factors. Psychiatric and obstetric close monitoring as well as additional medical and social support are recommended to ensure a healthy pregnancy course in patients with a severe mental illness.

Differences in dental age of small gestational age children based on the severity of enamel dental defects

Small Gestational Age (SGA) is the term used for a new born baby with birth-severe below the 10th percentile on the intrauterine Lubchenco curve, due to Intra Uterine Growth Restriction (IUGR) which can cause defects of several organs such as deciduous teeth enamel. Dental age is the indicator for growth and development of the teeth that determine biological age which is more accurate than chronological age and could be determined by calcification or teeth eruption. The purpose of this study was to obtain dental age in SGA children based on the enamel defect severity level of deciduous teeth as compared to the chronological age. This study was a comparative analytic study with given sample size, conducted towards 18 SGA children aged 4-6 years old, and 21 children with Appropriate Gestational Age (AGA) aged 4-6 years old as the control group. Deciduous teeth enamel defect severity level determined by the developmental defect of enamel (DDE) score FDI modified. In order to determine the permanent teeth growth and development, the indicator was based on dental age using the panoramic radiograph with Dermijian method. The t-test was used to compare the permanent teeth dental age difference between SGA and AGA children as well as the permanent teeth dental age difference of SGA children based on the enamel defect severity level of deciduous teeth as seen in their chronological age. The result showed that there was a difference in the permanent teeth dental age between the SGA and AGA children at chronological ages of 4, ,5, and 6 years old (t count = 3,36; 2,35; and 3,49). Based on the average of permanent teeth dental age, the value of AGA children was higher than SGA children. Furthermore, it also showed that the severe score of EDS in the SGA children at the age of 4, 5, and 6 years old, their permanent teeth dental age was lower than the mild EDS (t count = 1,45). The conclusion of this study was the permanent teeth dental age in SGA children was lower than the AGA children as well as difference between the permanent teeth dental age in SGA children based on their deciduous teeth enamel defect severity, and the severe defect refered to slower permanent teeth dental age than the mild defect.

Thrombospondin-1 and blood pressure in 7-8-year-old children born low birth weight and small for gestational age

Background Thrombospondin-1 (TSP-1) is associated with endothelial damage, glomerular impairment, and hypertension. Low birth weight (LBW) and small for gestational age (SGA) children have higher risk of morbidity and mortality.Objective To assess for a possible association between TSP-1 level and blood pressure in children who were born low birth weight and small for gestational age.Methods We conducted a cross-sectional study from March to May 2015. Inclusion criteria were children who were born LBW and SGA in 2007-2008 at Prof. Dr. R. D. Kandou General Hospital, resided in Manado, North Sulawesi, had complete medical records, and whose parents consented to their participation. Exclusion criteria were children who were in puberty, obese, had renal disease, taking medications that affect blood pressure, or who were admitted to the hospital in the 2 weeks prior to enrollment. Data were analyzed using regression and simple correlation tests to assess for associations between TSP-1 and birth weight, as well as TSP-1 and blood pressure.Results Subjects’ mean TSP-1 level was 257.95 ng/dL. There was a strong negative correlation between TSP-1 and birth weight (r=-0.784; P&lt;0.0001). In addition, there were strong positive correlations between TSP-1 level and systolic blood pressure (r=0.718; P&lt;0.0001) as well as TSP-1 and diastolic blood pressure (r=0.670; P&lt;0.0001).Conclusion Higher TSP-1 is associated with higher systolic and diastolic blood pressure in 7-8-year-old children who were LBW and SGA at birth. Also, TSP-1 and birth weight have a strong negative correlation.

Thrombospondin-1 and blood pressure in 7-8-year-old children born low birth weight and small for gestational age

Background Thrombospondin-1 (TSP-1) is associated with endothelial damage, glomerular impairment, and hypertension. Low birth weight (LBW) and small for gestational age (SGA) children have higher risk of morbidity and mortality.Objective To assess for a possible association between TSP-1 level and blood pressure in children who were born low birth weight and small for gestational age.Methods We conducted a cross-sectional study from March to May 2015. Inclusion criteria were children who were born LBW and SGA in 2007-2008 at Prof. Dr. R. D. Kandou General Hospital, resided in Manado, North Sulawesi, had complete medical records, and whose parents consented to their participation. Exclusion criteria were children who were in puberty, obese, had renal disease, taking medications that affect blood pressure, or who were admitted to the hospital in the 2 weeks prior to enrollment. Data were analyzed using regression and simple correlation tests to assess for associations between TSP-1 and birth weight, as well as TSP-1 and blood pressure.Results Subjects’ mean TSP-1 level was 257.95 ng/dL. There was a strong negative correlation between TSP-1 and birth weight (r=-0.784; P&lt;0.0001). In addition, there were strong positive correlations between TSP-1 level and systolic blood pressure (r=0.718; P&lt;0.0001) as well as TSP-1 and diastolic blood pressure (r=0.670; P&lt;0.0001).Conclusion Higher TSP-1 is associated with higher systolic and diastolic blood pressure in 7-8-year-old children who were LBW and SGA at birth. Also, TSP-1 and birth weight have a strong negative correlation.

Assessment of neurodevelopment in children of different gestational age with neonatal seizures

To assess psychomotor development in infants with neonatal seizures (NS) born with different gestational age, by means of Bayley-III scales of infant and toddler development, in their corrected age of 1 year. The study included 52 infants, who had NS and were born with different gestational age: 28 weeks or less (n=26) - group I, 29-32 weeks (n=16) - group II, 33-36 weeks (n=3) - group III, 37-41 weeks (n=7) - group IV. The infants' neurodevelopment was evaluated in their corrected age of 1 year by means of N. Bayley scales of infant and toddler development, third edition: Cognitive, Language, Motor, Social-Emotional, and Adaptive Behavior. Only 17 (32,7%) of 52 examined infants did not demonstrate any developmental delay on each of five Bayley-III scales. Significant developmental delay (composite score <70) on at least one scale was revealed in 23 (44,2%) patients, including 12 (46,2%) in group I, 5 (31,3%) in group II, 6 (60%) of 10 in the combined group III-IV. In most cases, neurodevelopmental delays were attributed to only one domain and could be indicated as partial. The conclusion about global developmental retardation (the composite scores 55 or less on all five scales) was done in 3 patients, each of whom had a co-morbidity of cerebral palsy and epilepsy.

The hearing function in the premature children following their treatment with the use of ototoxic antibiotics

The objective of the present study was the evaluation of the state of the auditory function in the premature children during the first year of life who underwent the neonatal treatment with various ototoxic antibiotics. A total of 232 newborn infants were available for the examination by the methods designed for recording distortion product optoacoustic emission (DPOAE) and short-latency auditory evoked potentials (SAEPs). The 'Statgraphics Centurion XV' program was used for the statistical treatment of the data obtained in the study. The results of recording DPOAE and SAEPs in 232 prematurely born children of different gestational age were used to evaluate their auditory function under conditions of treatment with various ototoxic antibiotics during the early neonatal period. It was shown that such treatment is likely to have an impact on the hearing function of premature children throughout the entire first year of life. Such influence can manifest itself as the enhanced threshold of the appearance of SAEPs peak V and the selective distortion of evoked responses recorded with the help of the DPOAE technique at a frequency of 4.6 kHz. It is concluded that all prematurely born children should be under observation of an otorhinolaryngologist-surdologist throughout the entire first year of life and, if appropriate, undergo the rehabilitative treatment at the earliest possible time. Moreover, the children with this condition must remain under the thorough follow-up care during at least 3 years including the yearly audiological evaluation and the comparative analysis of the results of previous observations for the timely identification of possible disturbances in the hearing function.

Catch-Up Growth and Neurobehavioral Development among Full-Term, Small-for-Gestational-Age Children: A Nationwide Japanese Population-Based Study

To examine the relationship between catch-up growth of full-term, small for gestational age (SGA) children and their neurobehavioral development. Data were obtained from a population-based nationwide Japanese longitudinal survey that started in 2001. Study participants were full-term children with information on height at 2 years of age (n = 32 533). Catch-up growth for SGA infants was defined as achieving a height at 2 years of age of more than -2.0 standard deviations for chronological age. Logistic regression analyses were used to estimate ORs and 95% CIs for the associations of SGA and catch-up growth status with neurobehavioral development at 2.5 and 8 years of age, adjusting for potential infant- and parent-related confounding factors. Fifteen percent of term SGA infants failed to catch up in height. At 2.5 years of age, SGA children without catch-up growth were more likely to be unable to climb stairs (OR, 10.42; 95% CI, 5.55-19.56) and unable to compose a 2-word sentence (OR, 3.58; 95% CI, 1.81-7.08) compared with children with normal growth at birth. Furthermore, SGA children without catch-up growth were at increased risk for aggressive behaviors (OR, 3.85; 95% CI, 1.19-12.47) at 8 years of age. Continuous follow-up for full-term SGA infants with failure of catch-up growth or poor postnatal growth may be beneficial for early detection and intervention for behavioral problems.

Growth hormone reverses dyslipidemia in adult offspring after maternal undernutrition

The abnormal intrauterine milieu of fetal growth retardation could lead to dyslipidemia in adulthood. Studies have shown that growth hormone (GH) therapy in small for gestational age (SGA) children would be beneficial for metabolic parameters. Here we investigated whether GH treatment introduced at adolescent period in SGA could reverse dyslipidemia during later life. SGA rat model was established by using semi-starvation treatment during the whole pregnancy. SGA or appropriate for gestational age (AGA) offspring were assigned to receive GH or normal saline (NS). Once-daily subcutaneous injections of GH were administered between 21–35 days of age. In adulthood, as compared to AGA, SGA showed: (1) decreased body weight and length; (2) increased serum triglycerides; (3) down-regulated hepatic AMPK-α1 but up-regulated SREBP-1c and ACC-1; (4) a significant reduction in histone H3 acetylation at the promoter of AMPK-α1. Exogenous GH administration led to a restoration of body weight and length and normalized serum triglycerides by reversing expression of AMPK-α1 and its targeted genes SREBP-1c and ACC-1, through increasing H3 acetylation at the promoter of AMPK-α1 in SGA in adult period. These results demonstrated positive effects on lipid metabolism by a short treatment course of GH in SGA adult period.

THE HISTOLOGICAL STUDY OF THE STRUCTURES OF THE ANTERIOR CHAMBER ANGLE IN THE CHILDREN OF DIFFERENT GESTATIONAL AGE UNDER THE NORMAL CONDITIONS AND IN THE PRESENCE OF CONGENITAL GLAUCOMA

Purpose. The objective of the present study was to obtain and investigate the tissue samples taken from the anterior chamber angle of the children of different gestational age under the normal conditions and in the presence of congenital glaucoma; the secondary objective was to carry out the histological study of the pieces of tissues removed from the glaucoma patients of different gestational age undergoing hypotensive filtration surgery (sinusotrabeculectomy). Materials and methods. The anterior chamber angle histological preparations from a total of five enucleated eyes were available for the intravital investigation of the trabecular meshwork (two of them were obtained from the full-term infants and one from a premature baby). Results. The histological study of the structures of the anterior chamber angle of the enucleated eyes has demonstrated the presence in all the cases of cornea, Descemet’s membrane, trabecular meshwork, Schlemm’s canal, and iris. The morphological structure of the anterior chamber angle associated with congenital glaucoma shows up some peculiar features compared with the normal one, such as its block by the permanent fibrous membrane which penetrates deep into the trabecular meshwork that, in its turn, is formed from the rough and thickened tissue. The histological picture of the fetal eye at different gestational age exhibits the open anterior chamber angle, the well developed porous trabecular meshwork, and fragmentation of Descemet’s membrane near the trabecular meshwork. No signs of fibrous degeneration of the trabecule have been apparent. Conclusion. The intravital investigation of the trabecular meshwork has demonstrated some peculiar features that differ depending on the gestational age in birth. In the full-term babies, it is hypoplastic and covered with the rough fibrous membrane at certain places. Its histological picture is similar to that of the preparations of the enucleated eyes. In the premature babies, the trabecular meshwork is fibrous and characterized by enhanced cellularity; it undergoes fibrous degeneration that becomes apparent after the birth of the premature child (it is supposed to be related to the proliferative processes inherent in such babies).

Final height and intrauterine growth retardation

Approximately 10% of small for gestational age (SGA) children maintain a small body size throughout childhood and often into adult life with a decreased pubertal spurt. Growth hormone (GH) therapy increases short-term growth in a dose–dependent manner and adult height had now been well documented. Shorter children might benefit from a higher dose at start (50μg/kg/day). The response to GH treatment was similar for both preterm and term short SGA groups and the effect of GH treatment on adult height showed a wide variation in growth response. As a whole, mean adult height is higher than −2 SDS in 60% of patients and 70% reached an adult height in their target height with better results with higher doses and combined GnRH analog therapy in those who were short at onset of puberty.

Growth hormone treatment in small for gestational age children in Spain

Abstract Introduction Since its approval by the European Medicines Agency, a great number of patients born small for gestational date have received recombinant growth hormone treatment in Spain. The aim of this study is to analyse its outcome in the setting of ordinary clinical practice. Methods Information was gathered from the registers of the assessment boards that authorise all growth hormone treatments prescribed in public hospitals in six autonomic communities (regions). Results Valid data from 974 patients was obtained. All of them complied with criteria established by the European Medicines Agency. Patients in the sample were smaller in length than weight at birth, with their median target height being below 1 standard deviation (SD), and 23% of them had been delivered prematurely. Treatment was started at 7.2 ± 2.8 years (mean ± SD). The mean patient height at start was −3.1 ± 0.8 SD. They gained 0.7 ± 0.2 SD in the first year, and 1.2 ± 0.8 SD after two years. Final height was attained by 8% of the sample, reaching −1.4 ± 0.7 SD. Conclusions These results are similar to other Spanish and international published studies, and are representative of the current practice in Spain. Despite treatment being started at a late age, adequate growth is observed in the short term and in the final height. Up to a 24% of patients show a poor response in the first year.

Early-life exposures predicting onset and resolution of childhood overweight or obesity

ObjectivesTo determine which of multiple early-life exposures predict onset or resolution of overweight/obesity during a 9-year period.MethodsDesign: longitudinal cohort from three harmonised community-based cohorts enriched for overweight and obesity. Early-life...

Face recognition impairment in small for gestational age and preterm children

BackgroundInfants born prematurely or with low birth weight are at increased risk of visual perceptual impairment. Face recognition is a high-order visual ability important for social development, which has been rarely assessed in premature or low birth weight children. AimsTo evaluate the influence of prematurity and low birth weight on face recognition skills. MethodsSeventy-seven children were evaluated as part of a prospective cohort study. They were divided into premature and term birth cohorts. Children with a birth weight below the 10th centile were considered small for gestational age. All children underwent a full ophthalmologic assessment and evaluation of face recognition skills using the Facial Memory subtest from the Test of Memory and Learning. ResultsPremature infants scored worse on immediate face recognition compared to term infants. However, after adjusting for birth weight, prematurity was not associated with worse outcomes. Independent of gestational age, outcomes of low birth weight children were worse than those of appropriate birth weight children, for immediate face recognition (odds ratio [OR], 5.14; 95% confidence interval [CI], 1.32–21.74) and for face memory (OR, 4.48; 95% CI, 1.14–16.95). ConclusionsBeing born small for gestational age is associated with suboptimal face recognition skills, even in children without major neurodevelopmental problems.

Postnatal systemic inflammation and neuro-ophthalmologic dysfunctions in extremely low gestational age children.

Compared to infants born at term, children born very preterm are at increased risk of visual dysfunctions and neonatal systemic inflammation. Here, we explore whether these two propensities are related. As part of the ELGAN study, the concentrations of 16 mediators of inflammation were measured in blood obtained on postnatal days 1, 7, 14, 21 and 28 from 1062 children born before the 28th week of gestation. Presence of visual field deficit, strabismus and/or impaired visual fixation was recorded at age two. The concentrations of each protein were divided into quartiles within gestational week categories. We calculated odds ratios with 99% confidence intervals for having each disorder comparing children with concentration in the top quartile of each protein to children whose concentration was in the lower quartiles on the corresponding day. Analyses were adjusted for gestational age and birth weight Z-score. Only one of 80 assessments (16 proteins on five different days) was significant for visual field deficit, and one for impaired fixation. No association was found between strabismus and any inflammatory mediator. None of the three neuro-ophthalmologic dysfunctions assessed at two years appears to be associated with systemic inflammation measured the first four postnatal weeks.

MICROVASCULAR ABNORMALITIES IN NEWBORNS OF DIFFERENT GESTATIONAL AGE WITH HYPOXIC-ISCHEMIC CNS LESION

The article presents results of a comparative analysis of microcirculation parameters in newborns with CNS hypoxic-ischemic lesion (CNS HIL) in different gestational age: 37–40 weeks (50 children), 34–36 weeks (55 children), 30–33 weeks (53 children). The study of microcirculation parameters was performed by biomicroscopy of bulbar conjunctiva with further morphometric image processing in dynamics: on 5–7 days of life and at the end of the neonatal period (21–28 days). The study revealed dependence of microvascular changes from gestational age in children with CNS HIL. The most critical is the group of children with 30–33 weeks of gestation. Even by the end of the neonatal period in children of this group venous drainage in microvasculature is not adequate to arterial inflow, which cause venous stasis and demonstrates the continuing microvascular disorders caused by unfinished angiogenesis process.

Study on growth hormone treatment in small for gestational age children

Abstract Objective To analyse the effectiveness of growth hormone (GH) therapy in short-stature children born small for gestational age (SGA) without catch-up growth (height at the beginning of treatment Materials and methods Anthropometric data from the SGA children were obtained from the database of the “Ministry of Health of Valencia”. These data were retrospectively reviewed. Results A total of 115 SGA children, with a mean age of 8.10 ± 2.75 years and height of −3.14 ± 0.59 SDS started treatment (dose: 0.035 ± 0.004 mg/kg/day) between January 1st, 2003 and March 31st, 2013. After 2 years of therapy ( n = 115, age: 10.50 ± 2.72 years) the height SDS was −2.11 ± 0.66; and after 4 years ( n = 96, age: 12.65 ± 2.46 years) of −1.76 ± 0.75 SDS. This latest improvement in stature matches ages at which the growth spurt usually occurs. Only 35 out of 115 children reached adult height, although impaired (−2.22 ± 0.86 SDS), and failed to achieve their target height (−1.72 ± 0.75 SDS). However, this sub-group grew to near the height of the shorter parent (−1.95 ± 1.28 SDS), and 42.9% of these 35 cases increased their stature by more than 1 SDS. Conclusions The studied sample did not achieve satisfactory growth results, as in other published series. Our findings might be improved by starting treatment earlier, and with doses individualised according to patient characteristics.

Self-reported pregnancy exposures and placental DNA methylation in the MARBLES prospective autism sibling study.

Human placenta is a fetal-derived tissue that offers a unique sample of epigenetic and environmental exposures present in utero. In the MARBLES prospective pregnancy study of high-risk younger siblings of children with autism spectrum disorder (ASD), pregnancy and environmental factors collected by maternal interviews were examined as predictors of placental DNA methylation, including partially methylated domains (PMDs), an embryonic feature of the placental methylome. DNA methylation data from MethylC-seq analysis of 47 placentas of children clinically diagnosed at 3 years with ASD or typical development using standardized assessments were examined in relation to: child’s gestational age, birthweight, and diagnosis; maternal pre-pregnancy body mass index, smoking, education, parity, height, prenatal vitamin and folate intake; home ownership; pesticides professionally applied to lawns or gardens or inside homes, pet flea/tick pouches, collars, or soaps/shampoos used in the 3 months prior to or during pregnancy. Sequencing run, order, and coverage, and child race and sex were considered as potential confounders. Akaike information criterion was used to select the most parsimonious among candidate models. Final prediction models used sandwich estimators to produce homoscadisticity-robust estimates of the 95% confidence interval (CI) and P-values controlled the false discovery rate at 5%. The strongest, most robust associations were between pesticides professionally applied outside the home and higher average methylation over PMDs [0.45 (95% CI 0.17, 0.72), P = 0.03] and a reduced proportion of the genome in PMDs [−0.42 (95% CI − 0.67 to − 0.17), P = 0.03]. Pesticide exposures could alter placental DNA methylation more than other factors.

Being born large for gestational age is associated with earlier pubertal take-off and longer growth duration: a longitudinal study.

Perinatal factors seem to influence the onset of puberty, but there is limited information on the potential effect of large size at birth on pubertal growth. This study evaluated pubertal growth in children born large for gestational age (LGA) compared to children born appropriate for gestational age (AGA). Longitudinal growth data collected from 70 children - 40 AGA and 30 LGA - were analysed. The ages at take-off, peak height velocity, final height and pubertal growth spurts were calculated using the Preece-Baines model I. Large for gestational age children showed an earlier age at take-off compared to AGA children (10.1 ± 1.2 versus 11.0 ± 1.4 years, p = 0.007), whereas the age at peak height velocity and at final height was similar. LGA children showed a longer growth spurt duration (2.5 ± 1 versus 1.5 ± 1.2 years, p < 0.001) and total pubertal duration (5.3 ± 1.2 versus 4.6 ± 1.2 years, p = 0.036) than AGA children. Results were similar when stratified by sex. Being born LGA was associated with an earlier pubertal take-off and longer growth duration. These unique findings, due to the lack of studies on pubertal growth patterns in LGA children, might lead the way to novel research and a different approach to LGA children at the onset of pubertal growth.