摘要
Background: Perinatal stress is thought to underlie the Barker sequelae of low birth weight, of which precocious pubarche may be a manifestation.Aims: To explore whether prematurity as well as smallness for gestational age (SGA) predisposes to precocious pubarche, and the potential role of excess weight gain during childhood.Methods: Retrospective chart review of 89 children (79 girls) with precocious pubarche.Results: Sixty five per cent were overweight/obese at diagnosis, compared with 19-24%of Australian children.Thirty five per cent had a history of SGA and 24%of prematurity.Weight SDS increased from birth to diagnosis in 91%of children.The mean change in weight SDS from birth to diagnosis was greater in those who were SGA (2.8, 95%CI 2.2 to 3.4) versus AGA (1.7, 95%CI 1.3 to 2.2), with no difference in the incidence of over weight/obesity.The latter was lower among children born premature (40%versus 72%term) but was associated with a mean increase in weight of 1.3 SDS during childhood.Nine out of ten girls and boys with precocious pubarche had at least one of the three risk factors studied.Conclusions: Both prematurity and SGA were associated with precocious pubarche, as was overweight/ obesity, irrespective of size or gestation at birth.Excess weight gain in childhood may predispose to precocious pubarche in susceptible individuals.
Background: Perinatal stress is thought to underlie the Barker sequelae of low birth weight, of which precocious pubarche may be a manifestation.Aims: To explore whether prematurity as well as smallness for gestational age (SGA) predisposes to precocious pubarche, and the potential role of excess weight gain during childhood.Methods: Retrospective chart review of 89 children (79 girls) with precocious pubarche.Results: Sixty five per cent were overweight/obese at diagnosis, compared with 19-24%of Australian children.Thirty five per cent had a history of SGA and 24%of prematurity.Weight SDS increased from birth to diagnosis in 91%of children.The mean change in weight SDS from birth to diagnosis was greater in those who were SGA (2.8, 95%CI 2.2 to 3.4) versus AGA (1.7, 95%CI 1.3 to 2.2), with no difference in the incidence of over weight/obesity.The latter was lower among children born premature (40%versus 72%term) but was associated with a mean increase in weight of 1.3 SDS during childhood.Nine out of ten girls and boys with precocious pubarche had at least one of the three risk factors studied.Conclusions: Both prematurity and SGA were associated with precocious pubarche, as was overweight/ obesity, irrespective of size or gestation at birth.Excess weight gain in childhood may predispose to precocious pubarche in susceptible individuals.
