Early-life growth linked to pubertal timing

medwireNews: A large study shows that growth in the first 5 years of life is associated with age at pubertal onset.

“Our findings are in line with previous studies that have examined associations between child growth and pubertal onset”, say Izzuddin Aris (Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA) and study co-authors.

They add: “The most clinically relevant implication of these findings is that children with faster gains in weight, length or height, or BMI immediately after birth, during late infancy, or in early childhood may need to be monitored closely for earlier onset of puberty and referred as appropriate for supportive services.”

The team obtained data from 36 cohorts included in the Environmental Influences on Child Health Outcomes programme, covering a period from 1986 to 2015.

Among the 3723 boys, each 1 standard deviation faster weight gain was significantly associated with younger age at peak height velocity (APHV), which the researchers “used as an objective marker of pubertal timing”.

This was the case for weight gain in early infancy (0–0.5 years), late infancy (0.5–2 years) and early childhood (2–5 years), and the associations were independent of multiple maternal and child confounders.

The researchers found similar results for length/height velocities and for BMI increases. However, growth measures were not associated with time of pubertal onset as judged by Tanner staging or the Pubertal Development Scale.

There was a more mixed picture in the 3772 girls studied, Aris and team report in JAMA Network Open.

Faster gains in weight, length or height in early childhood, but not at any other time, was associated with younger APHV in girls. In addition, faster weight gain or BMI gain in early childhood was associated with an increased risk of earlier puberty onset according to Tanner staging, and faster BMI gain in late infancy was associated with an increased risk of earlier menarche. Growth velocity was not associated with puberty onset as assessed by the Pubertal Development Scale, however.

“Taken together, findings of the present study suggest that faster growth during the first 5 years of life could be a potential indicator to identify children who are likely to experience earlier pubertal onset”, say the study authors.

But they caution that “growth patterns are not exposures in the true sense”, saying that growth in infancy and early childhood “is likely the result of exposure to other factors related to growth and body composition (eg, upstream social factors, diet and other environmental exposures, and physical activity), and these exposures most likely affect health status later in life.”

By Eleanor McDermid

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

JAMA Netw Open 2022; 5: e2146873
Martin Savage
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