Advanced Pubertal Growth Spurt in Subjects Born Preterm: The Helsinki Study of Very Low Birth Weight Adults

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. (J Clin Endocrinol Metab 96: 525-533, 2011)