Novel insights into the endocrine-metabolic and reproductive consequences of prenatal growth restraint in girls. Girls-born-small become women-born-small.

Emerging evidence indicates that prenatal growth relates to common disease in adulthood. Here, we review and embed a selection of advances within this field of research. Focus is on endocrine-metabolic and reproductive facets in girls and young women, who experienced a degree of prenatal growth restraint. Such early restraint has now been linked to variable constellations including the following: hyperinsulinemia; dyslipidemia; central adiposity; exaggerated adrenarche and precocious pubarche; early and rapidly progressive puberty; ovarian hyperandrogenism; elevated serum FSH and/or LH; small uterine and/or ovarian size; and oligo- or an-ovulation. Hyperinsulinemic insulin resistance is thought to be a prime pathogenetic factor. Accordingly, insulin sensitization is among the first therapeutic strategies explored, so far, with promising results.