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, age at 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 dehydroepiandrosterone sulfate (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 at menarche. 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 final height 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 10.4 years 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 + 0.18 microgram/ml vs 0.57 + 0.22 microgram/ml, p < 0.05) were significantly higher in SGA girls than in control subjects. We concluded that full-term born-SGA females have impaired final 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 maturation in childhood with a reduced final height. In our population a progressive increment in final stature is evident.

Puberty in Children Born Small for Gestational Age

“…Although menarche occurred within the normal age range in all girls, it was significantly earlier in the SGA compared to the AGA group [31] (table 2). A slightly earlier age at menarche in girls born light for gestational age was also reported in the Swedish study [30,34] (table 2). …”

Early menarche is associated with metabolic syndrome and insulin resistance in premenopausal Korean women

“…In a longitudinal cohort study, SGA children had greater adiposity and insulin resistance during catch-up growth [17]. SGA girls had an early puberty and a lower age at menarche compared to control [14]. After menarche, SGA girls also showed hyperinsulinemia, higher androgen, and lower SHBG levels [19].…”

Problems related to menstruation amongst adolescent girls

“…Thus, the girls between 10-13 years were exempted from the study since the mean age of menarche has been reported to be 12 yrs. 2 A total of 204 adolescent girls in the age group of 13-19 years were enumerated. Two of them had menarche for less than one year and four could not be contacted even on three consecutive visits; hence had to be dropped from the study.…”

“…From both social and medical perspectives it is often considered the central event of female puberty, as it signals the possibility of fertility.The age of onset of menstruation varies from 9 to 18 years with the average age in United States being about 12 years and 8 months, whereas in India it is slightly lower and has been reported to be around 12 years. 2,3,4,5 Menarche further calls for special attention because of the physical and emotional problems associated with it.…”