Advanced pubertal growth spurt in subjects born preterm: the Helsinki study of very low birth weight adults

Karoliina Wehkalampi, Petteri Hovi, Leo Dunkel, Sonja Strang-Karlsson, Anna-Liisa Järvenpää, Johan G Eriksson, Sture Andersson, Eero Kajantie
Journal of Clinical Endocrinology and Metabolism 2011, 96 (2): 525-33

CONTEXT: Among people born at term, low birth weight is associated with early puberty. Early maturation may be on the pathway linking low birth weight with cardiovascular disease and type 2 diabetes. Subjects born preterm with very low birth weight (VLBW; <1500 g) have as adults increased risk factors for cardiovascular disease. Little is known about their pubertal timing.

OBJECTIVE: The objective of the investigation was to study the timing of pubertal growth in subjects born preterm with VLBW as compared with controls.

DESIGN, SETTING, AND PARTICIPANTS: A follow-up study of subjects born preterm including 188 VLBW and 190 term-born control subjects. Growth data were available for 128 VLBW and 147 control subjects, of whom we excluded 15 and 1, respectively, because of neurological impairment.

MAIN OUTCOME MEASURE: Timing of pubertal growth spurt was estimated by assessing the ages, corrected for gestational age at birth, at acceleration (take-off) and peak height velocity of pubertal growth, and age at attaining adult height.

RESULTS: All components of pubertal growth occurred earlier in VLBW subjects than in controls. Age at take-off was 0.8 yr earlier [95% confidence interval (CI) 0.4-1.3] in VLBW subjects born appropriate and 0.9 yr earlier (95% CI 0.4-1.5) in those born small for gestational age. VLBW subjects were more likely to have a pubertal growth spurt that was at least 2 yr earlier than population average [odds ratio 3.8 (95% CI: 1.5-9.6)].

CONCLUSIONS: Prematurity per se is associated with advanced pubertal growth. Advanced puberty may be among the factors mediating adult metabolic outcomes in subjects born preterm with VLBW.

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