Hokken-Koèlega Anita C S
Department of Paediatrics, Subdivision of Endocrinology, Sophia Children's Hospital, Erasmus University Medical Center, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
Best Pract Res Clin Endocrinol Metab. 2002 Mar;16(1):65-71. doi: 10.1053/beem.2002.0181.
Children born small for gestational age (SGA: birth weight or birth length more than 2 standard deviations below the mean score) are at a higher risk of perinatal morbidity and mortality and of a number of chronic diseases in later life such as hypertension, decreased insulin sensitivity, diabetes mellitus type 2 and an increased risk of cardiovascular disease. The programming of the endocrine axes occurs during critical phases of fetal development and might thus be affected by intrauterine growth retardation. Studies in Northern Spanish adolescent girls have indicated associations between reduced fetal growth and the occurrence of precocious adrenarche, pubarche, hyperandrogenism, polycystic ovary syndrome (PCOS) and hyperinsulinism. These findings have attracted much attention because it might have serious consequences in later life. However, hyperandrogenism and precocious pubarche were not confirmed in a large Dutch study in short children born SGA. Two studies reported a lower number of follicles in the ovaries in girls born SGA, which might have an impact on fertility. Clearly, further studies are required before definite conclusions can be drawn. There are still only limited data concerning the timing of puberty in children born SGA. Most studies indicate that these children start their puberty at a normal age but relatively early within the normal range. Age at menarche seems comparable with controls. Data on duration of puberty, influence of puberty on attainment of adult height, peak height velocity during puberty and fertility are not yet known.
小于胎龄儿（SGA：出生体重或出生身长低于平均分数2个标准差以上）出生时发生围产期发病和死亡以及日后患多种慢性疾病如高血压、胰岛素敏感性降低、2型糖尿病和心血管疾病风险增加。内分泌轴的程序化发生在胎儿发育的关键阶段，因此可能受宫内生长迟缓的影响。对西班牙北部青春期女孩的研究表明，胎儿生长受限与性早熟、阴毛早现、高雄激素血症、多囊卵巢综合征（PCOS）和高胰岛素血症之间存在关联。这些发现备受关注，因为其可能在日后生活中产生严重后果。然而，在一项针对SGA出生的矮小儿童的大型荷兰研究中，并未证实高雄激素血症和阴毛早现。两项研究报告称，SGA出生女孩的卵巢卵泡数量较少，这可能对生育能力产生影响。显然，在得出明确结论之前还需要进一步研究。关于SGA出生儿童青春期时间的现有数据仍然有限。大多数研究表明，这些儿童在正常年龄开始青春期，但在正常范围内相对较早。初潮年龄似乎与对照组相当。关于青春期持续时间、青春期对成年身高达成的影响、青春期峰值身高速度和生育能力的数据尚不清楚。
