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.

Barker DJ, Gluckman PD, Godfrey KM, Harding JE, Owens JA, Robinson JS: Fetal nutrition and cardiovascular disease in adult life. Lancet 1993;341:938–941.
Botero D, Lifshitz F: Intrauterine growth retardation and long-term effects on growth. Curr Opin Pediatr 1999;11:340–347.
Westwood M, Kramer MS, Munz D, Lovett JM, Watters GV: Growth and development of full-term nonasphyxiated small-for-gestational-age newborns: follow-up through adolescence. Pediatrics 1983;71:376–382.
Job JC, Rolland A: Natural history of intrauterine growth retardation: pubertal growth and adult height. Arch Fr Pediatr 1986;43:301–306.
Fitzhardinge PM, Inwood S: Long-term growth in small-for-date children. Acta Paediatr Scand Suppl 1989;349:27–33.
Albertsson-Wikland K, Karlberg J: Natural growth in children born small for gestational age with and without catch-up growth. Acta Paediatr Suppl 1994;399:64–70.
Chaussain JL, Colle M, Ducret JP: Adult height in children with prepubertal short stature secondary to intrauterine growth retardation. Acta Paediatr Suppl 1994;399:72–73.
Hokken-Koelega AC, De Ridder MA, Lemmen RJ, Den Hartog H, De Muinck Keizer-Schrama SM, Drop SL: Children born small for gestational age: do they catch up? Pediatr Res 1995;38:267–271.
Léger J, Levy-Marchal C, Bloch J, Pinet A, Chevenne D, Porquet D, Collin D, Czernichow P: Reduced final height and indications for insulin resistance in 20 year olds born small for gestational age: regional cohort study. BMJ 1997;315:341–347.
Abbassi V: Growth and normal puberty. Pediatrics 1998;102(2 Pt 3):507–511.
Albertsson-Wikland K, Boguszewski M, Karlberg J: Children born small-for-gestational age: postnatal growth and hormonal status. Horm Res 1998;49(suppl 2):7–13.
Chatelain P, Job JC, Blanchard J, Ducret JP, Oliver M, Sagnard L, Vanderschueren-Lodeweyckx M: Dose-dependent catch-up growth after 2 years of growth hormone treatment in intrauterine growth-retarded children. Belgian and French Pediatric Clinics and Sanofi-Choay (France). J Clin Endocrinol Metab 1994;78:1454–1460.
De Zegher F, Maes M, Gargosky SE, Heinrichs C, Du Caju MV, Thiry G, De Schepper J, Craen M, Breysem L, Lofstrom A, Jonsson P, Bourguignon JP, Malraux P, Rosenfeld RG: High-dose growth hormone treatment of short children born small for gestational age. J Clin Endocrinol Metab 1996;81:1887–1892.
Chernausek SD, Breen TJ, Frank GR: Linear growth in response to growth hormone treatment in children with short stature associated with intrauterine growth retardation: the National Cooperative Growth Study experience. J Pediatr 1996;128:S22-S27.
Sas T, de Waal W, Mulder P, Houdijk M, Jansen M, Reeser M, Hokken-Koelega A: Growth hormone treatment in children with short stature born small for gestational age: 5-year results of a randomized, double-blind, dose-response trial. J Clin Endocrinol Metab 1999;84:3064–3070.
Darendeliler F, Hindmarsh PC, Preece MA, Cox L, Brook CG: Growth hormone increases rate of pubertal maturation. Acta Endocrinol (Copenh) 1990;122:414–416.
Stanhope R, Albanese A, Hindmarsh P, Brook CG: The effects of growth hormone therapy on spontaneous sexual development. Horm Res 1992;38(suppl 1):9–13.
Frisch H, Birnbacher R: Final height and pubertal development in children with growth hormone deficiency after long-term treatment. Horm Res 1995;43:132–134.
Usher R, McLean F: Intrauterine growth of live-born Caucasian infants at sea level: standards obtained from measurements in 7 dimensions of infants born between 25 and 44 weeks of gestation. J Pediatr 1969;74:901–910.
Coutant R, Carel JC, Letrait M, Bouvattier C, Chatelain P, Coste J, Chaussain JL: Short stature associated with intrauterine growth retardation: final height of untreated and growth hormone-treated children. J Clin Endocrinol Metab 1998;83:1070–1074.
Sempé M, Pédron G, Roy-Pernot MP: Auxologie, méthode et séquences. Paris, Théraplix, 1979.
Ranke MB: Towards a consensus on the definition of idiopathic short stature. Horm Res 1996;45(suppl 2):64–66.
Rolland-Cachera MF, Cole TJ, Sempé M, Tichet J, Rossignol C, Charraud A: Body mass index variations: centiles from birth to 87 years. Eur J Clin Nutr 1991;45:13–21.
Marshall WA, Tanner JM: Variations in pattern of pubertal changes in girls. Arch Dis Child 1969;44:291–303.
Marshall WA, Tanner JM: Variations in the pattern of pubertal changes in boys. Arch Dis Child 1970;45:13–23.
Greulich WW, Pyle SI: Radiographic Atlas of Skeletal Development of the Hand and Wrist, ed 2. Stanford, Stanford University Press, 1959.
Marshall WA: Interrelationship of skeletal maturation, sexual development and somatic growth in man. Ann Hum Biol 1974;1:29–40.
Persson I, Ahlsson F, Ewald U, Tuvemo T, Qingyuan M, von Rosen D, Proos L: Influence of perinatal factors on the onset of puberty in boys and girls: implications for interpretation of link with risk of long term diseases. Am J Epidemiol 1999;150:747–755.
Rekers-Mombarg LT, Kamp GA, Massa GG, Wit JM: Influence of growth hormone treatment on pubertal timing and pubertal growth in children with idiopathic short stature. Dutch Growth Hormone Working Group. J Pediatr Endocrinol Metab 1999;12:611–622.
Bourguignon JP: Linear growth as a function of age at onset of puberty and sex steroid dosage: therapeutic implications. Endocr Rev 1988;9:467–488.
Rensonnet C, Kanen F, Coremans C, Ernould C, Albert A, Bourguignon JP: Pubertal growth as a determinant of adult height in boys with constitutional delay of growth and puberty. Horm Res 1999;51:223–229.
Leger J, Limoni C, Collin D, Czernichow P: Prediction factors in the determination of final height in subjects born small for gestational age. Pediatr Res 1998;43:808–812.
Bayley N, Pinneau SR: Tables for predicting adult heights from skeletal age: revised for use with the Greulich-Pyle hand standards. J Pediatr 1952;40:423–441.
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