Puberty and prenatal growth.

There is increasing evidence for a link between puberty and prenatal growth. Here we highlight a selection of pubertal characteristics in children who were born small-for-gestational-age (SGA). Boys born SGA are at risk for high FSH and low inhibin B levels, and a small testicular volume in adolescence. In girls born SGA, the age at pubertal onset and the age at menarche are advanced by about 5-10 months; prenatal growth restraint may be associated with higher FSH levels and with small internal genitalia in adolescence. The ovulation rate was found to be low in SGA adolescents, and an insulin-sensitizing therapy was capable of raising this low ovulation rate. Menarche is definitely advanced in SGA girls with precocious pubarche. Current evidence suggests that insulin resistance is a key mechanism linking a post-SGA state to early menarche; hence, insulin sensitization may become a valid approach to prevent early menarche and early growth arrest in SGA girls.