Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2005 Mar;90(3):258–261. doi: 10.1136/adc.2004.053959

Precocious pubarche is associated with SGA, prematurity, weight gain, and obesity

K Neville 1, J Walker 1
PMCID: PMC1720316  PMID: 15723910

Abstract

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 overweight/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.

Full Text

The Full Text of this article is available as a PDF (66.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barker D. J. Fetal origins of coronary heart disease. BMJ. 1995 Jul 15;311(6998):171–174. doi: 10.1136/bmj.311.6998.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Barker D. J., Gluckman P. D., Godfrey K. M., Harding J. E., Owens J. A., Robinson J. S. Fetal nutrition and cardiovascular disease in adult life. Lancet. 1993 Apr 10;341(8850):938–941. doi: 10.1016/0140-6736(93)91224-a. [DOI] [PubMed] [Google Scholar]
  3. Barker D. J., Winter P. D., Osmond C., Margetts B., Simmonds S. J. Weight in infancy and death from ischaemic heart disease. Lancet. 1989 Sep 9;2(8663):577–580. doi: 10.1016/s0140-6736(89)90710-1. [DOI] [PubMed] [Google Scholar]
  4. Beeby P. J., Bhutap T., Taylor L. K. New South Wales population-based birthweight percentile charts. J Paediatr Child Health. 1996 Dec;32(6):512–518. doi: 10.1111/j.1440-1754.1996.tb00965.x. [DOI] [PubMed] [Google Scholar]
  5. Booth M. L., Wake M., Armstrong T., Chey T., Hesketh K., Mathur S. The epidemiology of overweight and obesity among Australian children and adolescents, 1995-97. Aust N Z J Public Health. 2001 Apr;25(2):162–169. doi: 10.1111/j.1753-6405.2001.tb01840.x. [DOI] [PubMed] [Google Scholar]
  6. Charkaluk Marie-Laure, Trivin Christine, Brauner Raja. Premature pubarche as an indicator of how body weight influences the onset of adrenarche. Eur J Pediatr. 2003 Dec 19;163(2):89–93. doi: 10.1007/s00431-003-1358-9. [DOI] [PubMed] [Google Scholar]
  7. Cole T. J., Bellizzi M. C., Flegal K. M., Dietz W. H. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000 May 6;320(7244):1240–1243. doi: 10.1136/bmj.320.7244.1240. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Dimartino-Nardi J. Premature adrenarche: findings in prepubertal African-American and Caribbean-Hispanic girls. Acta Paediatr Suppl. 1999 Dec;88(433):67–72. doi: 10.1111/j.1651-2227.1999.tb14406.x. [DOI] [PubMed] [Google Scholar]
  9. Eriksson J. G., Forsén T., Tuomilehto J., Osmond C., Barker D. J. Early growth and coronary heart disease in later life: longitudinal study. BMJ. 2001 Apr 21;322(7292):949–953. doi: 10.1136/bmj.322.7292.949. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Fay R. A., Dey P. L., Saadie C. M., Buhl J. A., Gebski V. J. Ponderal index: a better definition of the 'at risk' group with intrauterine growth problems than birth-weight for gestational age in term infants. Aust N Z J Obstet Gynaecol. 1991 Feb;31(1):17–19. doi: 10.1111/j.1479-828x.1991.tb02755.x. [DOI] [PubMed] [Google Scholar]
  11. Forbes G. B., Brown M. R., Welle S. L., Underwood L. E. Hormonal response to overfeeding. Am J Clin Nutr. 1989 Apr;49(4):608–611. doi: 10.1093/ajcn/49.4.608. [DOI] [PubMed] [Google Scholar]
  12. Francois I., de Zegher F. Adrenarche and fetal growth. Pediatr Res. 1997 Mar;41(3):440–442. doi: 10.1203/00006450-199703000-00023. [DOI] [PubMed] [Google Scholar]
  13. Goland R. S., Jozak S., Warren W. B., Conwell I. M., Stark R. I., Tropper P. J. Elevated levels of umbilical cord plasma corticotropin-releasing hormone in growth-retarded fetuses. J Clin Endocrinol Metab. 1993 Nov;77(5):1174–1179. doi: 10.1210/jcem.77.5.8077309. [DOI] [PubMed] [Google Scholar]
  14. Guaran R. L., Wein P., Sheedy M., Walstab J., Beischer N. A. Update of growth percentiles for infants born in an Australian population. Aust N Z J Obstet Gynaecol. 1994 Feb;34(1):39–50. doi: 10.1111/j.1479-828x.1994.tb01037.x. [DOI] [PubMed] [Google Scholar]
  15. Hamill P. V., Drizd T. A., Johnson C. L., Reed R. B., Roche A. F., Moore W. M. Physical growth: National Center for Health Statistics percentiles. Am J Clin Nutr. 1979 Mar;32(3):607–629. doi: 10.1093/ajcn/32.3.607. [DOI] [PubMed] [Google Scholar]
  16. Hendrikx A., Heyns W., De Moor P. Influence of a low-calorie diet and fasting on the metabolism of dehydroepiandosterone sulfate in adult obese subjects. J Clin Endocrinol Metab. 1968 Nov;28(11):1525–1533. doi: 10.1210/jcem-28-11-1525. [DOI] [PubMed] [Google Scholar]
  17. Hines G. A., Smith E. R., Azziz R. Influence of insulin and testosterone on adrenocortical steroidogenesis in vitro: preliminary studies. Fertil Steril. 2001 Oct;76(4):730–735. doi: 10.1016/s0015-0282(01)02014-3. [DOI] [PubMed] [Google Scholar]
  18. Hofman P. L., Cutfield W. S., Robinson E. M., Bergman R. N., Menon R. K., Sperling M. A., Gluckman P. D. Insulin resistance in short children with intrauterine growth retardation. J Clin Endocrinol Metab. 1997 Feb;82(2):402–406. doi: 10.1210/jcem.82.2.3752. [DOI] [PubMed] [Google Scholar]
  19. Ibañez L., Potau N., Virdis R., Zampolli M., Terzi C., Gussinyé M., Carrascosa A., Vicens-Calvet E. Postpubertal outcome in girls diagnosed of premature pubarche during childhood: increased frequency of functional ovarian hyperandrogenism. J Clin Endocrinol Metab. 1993 Jun;76(6):1599–1603. doi: 10.1210/jcem.76.6.8501168. [DOI] [PubMed] [Google Scholar]
  20. Ibáez L., Dimartino-Nardi J., Potau N., Saenger P. Premature adrenarche--normal variant or forerunner of adult disease? Endocr Rev. 2000 Dec;21(6):671–696. doi: 10.1210/edrv.21.6.0416. [DOI] [PubMed] [Google Scholar]
  21. Ibáez L., Potau N., Francois I., de Zegher F. Precocious pubarche, hyperinsulinism, and ovarian hyperandrogenism in girls: relation to reduced fetal growth. J Clin Endocrinol Metab. 1998 Oct;83(10):3558–3562. doi: 10.1210/jcem.83.10.5205. [DOI] [PubMed] [Google Scholar]
  22. Ibáez L., Potau N., Zampolli M., Riqué S., Saenger P., Carrascosa A. Hyperinsulinemia and decreased insulin-like growth factor-binding protein-1 are common features in prepubertal and pubertal girls with a history of premature pubarche. J Clin Endocrinol Metab. 1997 Jul;82(7):2283–2288. doi: 10.1210/jcem.82.7.4084. [DOI] [PubMed] [Google Scholar]
  23. Ibáez L., de Zegher F., Potau N. Anovulation after precocious pubarche: early markers and time course in adolescence. J Clin Endocrinol Metab. 1999 Aug;84(8):2691–2695. doi: 10.1210/jcem.84.8.5883. [DOI] [PubMed] [Google Scholar]
  24. Ibáez Lourdes, Ferrer Angela, Ong Ken, Amin Rakesh, Dunger David, de Zegher Francis. Insulin sensitization early after menarche prevents progression from precocious pubarche to polycystic ovary syndrome. J Pediatr. 2004 Jan;144(1):23–29. doi: 10.1016/j.jpeds.2003.08.015. [DOI] [PubMed] [Google Scholar]
  25. Isomaa B., Almgren P., Tuomi T., Forsén B., Lahti K., Nissén M., Taskinen M. R., Groop L. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001 Apr;24(4):683–689. doi: 10.2337/diacare.24.4.683. [DOI] [PubMed] [Google Scholar]
  26. Kari M. A., Raivio K. O., Stenman U. H., Voutilainen R. Serum cortisol, dehydroepiandrosterone sulfate, and steroid-binding globulins in preterm neonates: effect of gestational age and dexamethasone therapy. Pediatr Res. 1996 Aug;40(2):319–324. doi: 10.1203/00006450-199608000-00021. [DOI] [PubMed] [Google Scholar]
  27. Law C. M., Barker D. J., Osmond C., Fall C. H., Simmonds S. J. Early growth and abdominal fatness in adult life. J Epidemiol Community Health. 1992 Jun;46(3):184–186. doi: 10.1136/jech.46.3.184. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Lee M. M., Rajagopalan L., Berg G. J., Moshang T., Jr Serum adrenal steroid concentrations in premature infants. J Clin Endocrinol Metab. 1989 Dec;69(6):1133–1136. doi: 10.1210/jcem-69-6-1133. [DOI] [PubMed] [Google Scholar]
  29. Ong K. K., Ahmed M. L., Emmett P. M., Preece M. A., Dunger D. B. Association between postnatal catch-up growth and obesity in childhood: prospective cohort study. BMJ. 2000 Apr 8;320(7240):967–971. doi: 10.1136/bmj.320.7240.967. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Phillips D. I., Barker D. J., Hales C. N., Hirst S., Osmond C. Thinness at birth and insulin resistance in adult life. Diabetologia. 1994 Feb;37(2):150–154. doi: 10.1007/s001250050086. [DOI] [PubMed] [Google Scholar]
  31. Remer T., Manz F. Role of nutritional status in the regulation of adrenarche. J Clin Endocrinol Metab. 1999 Nov;84(11):3936–3944. doi: 10.1210/jcem.84.11.6093. [DOI] [PubMed] [Google Scholar]
  32. Rich-Edwards J. W., Stampfer M. J., Manson J. E., Rosner B., Hankinson S. E., Colditz G. A., Willett W. C., Hennekens C. H. Birth weight and risk of cardiovascular disease in a cohort of women followed up since 1976. BMJ. 1997 Aug 16;315(7105):396–400. doi: 10.1136/bmj.315.7105.396. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Rolland-Cachera M. F., Cole T. J., Sempé M., Tichet J., Rossignol C., Charraud A. Body Mass Index variations: centiles from birth to 87 years. Eur J Clin Nutr. 1991 Jan;45(1):13–21. [PubMed] [Google Scholar]
  34. Stein C. E., Fall C. H., Kumaran K., Osmond C., Cox V., Barker D. J. Fetal growth and coronary heart disease in south India. Lancet. 1996 Nov 9;348(9037):1269–1273. doi: 10.1016/s0140-6736(96)04547-3. [DOI] [PubMed] [Google Scholar]
  35. Turnipseed M. R., Bentley K., Reynolds J. W. Serum dehydroepiandrosterone sulfate in premature infants and infants with intrauterine growth retardation. J Clin Endocrinol Metab. 1976 Dec;43(6):1219–1225. doi: 10.1210/jcem-43-6-1219. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES