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.