Vicens-Calvet E, Espadero R M, Carrascosa A
Hospital Universitario Materno-Infantil Vall d'Hebron, Barcelona, Spain.
J Pediatr Endocrinol Metab. 2002 Apr;15(4):381-8. doi: 10.1515/jpem.2002.15.4.381.
Most children born small for gestational age (SGA) experience extensive catch-up growth during the first months of life (87%) and by the age of 2 years only 13% are below -2 SDS for height. The long-term outcome, including pubertal growth spurt, of the subset of children born SGA without postnatal catch-up (SGAWPC) has been evaluated in very few surveys, and in none of them was the landmarks of puberty well described. Thus, a longitudinal study was conducted in these children throughout puberty since this is the only reliable way to accurately evaluate the pubertal growth spurt. In an observational, retrospective and multicenter collaborative study, from an initial group of 553 SGA children, a subset of 15 boys (BW = 2,070 +/- 379.6 g) and 16 girls (BW = 2,244 +/- 331.1 g) SGAWPC whose data were recorded regularly during puberty were selected. Growth standards for growth and maturity during puberty were Tanner and Whitehouse and Spanish Hernandez and Sobradillo charts. In pubertal growth spurt, 'take-off' occurred later than in the reference populations with a height SDS deficiency of -2.3 and -2.2 for boys and -2.0 and -1.9 for girls, compared with Spanish and Tanner references, respectively. Peak height velocity was normal in chronology and intensity, but the total pubertal gain was smaller. However, considering their growth from the same chronological age at which the reference populations took off until adulthood, the total gain was not significantly different in the three cohorts (32.5 +/- 5.4 cm vs 30.9 +/- 4.4 in boys, and 23.3 +/- 4.1 vs 25.7 +/- 5.4 cm in girls - Spanish reference - and 27.2 +/- 6.3 vs 27.6 +/- 3.5 cm in boys - Tanner charts), except in the case of girls (21.1 +/- 3.9 vs 25.3 +/- 4.1 cm, p <0.005 - Tanner charts). Adult height was significantly reduced (161.9 +/- 3.9 cm in males and 147.0 +/- 2.6 cm in females). Therefore, although the pubertal growth was smaller in these children, puberty probably did not modify their short final height.
大多数小于胎龄儿（SGA）在出生后的头几个月会经历显著的追赶生长（87%），到2岁时，只有13%的儿童身高低于-2标准差（SDS）。对于出生时小于胎龄且出生后无追赶生长（SGAWPC）的儿童亚组，包括青春期生长突增在内的长期结局，在很少的调查中进行过评估，而且在这些调查中，没有一项对青春期的标志性特征进行了很好的描述。因此，对这些儿童从青春期开始进行了一项纵向研究，因为这是准确评估青春期生长突增的唯一可靠方法。在一项观察性、回顾性和多中心合作研究中，从最初的553名SGA儿童中，选取了15名男孩（出生体重=2070±379.6克）和16名女孩（出生体重=2244±331.1克）的SGAWPC亚组，他们在青春期的数据被定期记录。青春期生长和成熟的标准是坦纳和怀特豪斯以及西班牙的埃尔南德斯和索布拉迪略图表。在青春期生长突增中，与西班牙和坦纳参考标准相比，男孩的“开始”时间比身高SDS低于-2.3和-2.2、女孩低于-2.0和-1.9的参考人群晚。身高增长峰值在时间和强度上是正常的，但青春期的总增长较小。然而，考虑到他们从参考人群开始青春期的相同实际年龄到成年期的生长情况，三个队列的总增长没有显著差异（男孩为32.5±5.4厘米对30.9±4.4厘米，女孩为23.3±4.1厘米对25.7±5.4厘米——西班牙参考标准——男孩为27.2±6.3厘米对27.6±3.5厘米——坦纳图表），女孩除外（21.1±3.9厘米对25.3±4.1厘米，p<0.005——坦纳图表）。成人身高显著降低（男性为161.9±3.9厘米，女性为147.0±2.6厘米）。因此，尽管这些儿童的青春期生长较小，但青春期可能并未改变他们最终的矮小身高。
