Amplitude of pubertal growth in short stature children with intrauterine growth retardation

Abstract

Objective: Pubertal growth contributes to 15-18% of adult height. A blunted pubertal peak could contribute to short adult height in short children born with intrauterine growth retardation (IUGR).

Design and methods: Pubertal growth, from onset of puberty to final height, was investigated in 75 short IUGR children: 47 were treated with recombinant human growth hormone (GH) (tx) before pubertal onset (mean dose: 0.4 IU/kg/week); 28 were not treated (no-tx). They were compared with 98 normal children.

Results: Puberty occurred later in IUGR children than in controls (boys 14.2 +/- 1 years vs. 12.1 +/- 0.8 years; girls 12 +/- 1 years vs. 11.2 +/- 0.8 years; p < 0.0001). In girls, total pubertal growth was similar in all three groups (tx: 19.3 +/- 4.8 cm; no-tx 19.8 +/- 4.9 cm; controls 20.2 +/- 3.9 cm; non-significant). IUGR boys had a reduced pubertal growth (tx: 21.3 +/- 6.2 cm; no-tx: 23.9 +/- 6.1; controls 26.9 +/- 3.9 cm; p < 0.05). The age at puberty onset was the major determinant of pubertal growth amplitude (boys: r = 0.53, p < 0.001; girls: r = 0.45, p < 0.001). IUGR children exhibited little catch-up growth during puberty.

Conclusions: In the present study, we describe a delayed onset of puberty in short children born with IUGR. Moreover, prepubertal GH treatment was associated in boys with a decrease in the amplitude of the pubertal spurt, a finding that should be further evaluated in clinical trials.