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Minipuberty – an important and still neglected period of sexual development


Authors: Zapletalová Jiřina
Authors‘ workplace: Dětská klinika, Lékařská fakulta Univerzity Palackého a FN Olomouc
Published in: Čes-slov Pediat 2022; 77 (Supplementum 3): 5-10.
Category: Comprehensive Report
doi: https://doi.org/10.55095/CSPediatrie2022/052

Overview

Minipuberty is defined as temporary postnatal activation of the hypothalamic-pituitary-gonadal (HPG) axis. The HPG axis is triggered three times during lifetime. The first time in the middle of gestation, when it participates in the development and maturation of the sex glands. This is followed by the so-called minipuberty, which begins a few days after birth and lasts 4-6 months in boys and 2-4 years in girls. After the „hormonally sillent“ childhood comes classical sexual adolescence with the development of secondary sexual signs in the second decade of life and is completed by a complete maturation of the sex glands allowing future reproduction. The existence of mini-puberty has been known for almost 50 years, but its full meaning is still not clarified. Levels of sex hormones reach almost to the values of adult individuals during this period. In boys, the penis grows, testes increase in size, in which germ cells proliferate, in girls, estradiol stimulates the growth of mammary glands and the maturation of ovarian follicles. The physiological course of minipuberty is essential for future sexual development and fertility. At the same time, this period is several months‘ „window of opportunity“ of establishing a diagnosis of some congenital disorders of sexual development. In boys with hypogonadotropic hypogonadism, as well as with the possibility of early treatment. The clinical implications of minipuberty in premature babies and infants born young for their gestational age deserve special attention. Minipuberta is considered a real predicition of future sexual development.

Keywords:

estradiol – Luteinizing hormone – testosterone – Minipuberty – hypothalamic-pituitary-gonadal axis – follicle-stimulating hormone – diagnostic window


Sources
  1. Forest MG, Cathiard AM, Bertrand JA. Evidence of testicular activity in early infancy. J Clin Endocrinol Metab 1973; 37(1): 148–151.
  2. Winter JS, Faiman C, Hobson WC, et al. Pituitary-gonadal relations in infancy. Patterns of serum gonadotropin concentrations from birth to four years of age in man and chimpanzee. J Clin Endocrinol Metab 1975; 40(4): 545–551.
  3. Kaplan SL, Grumbach MM. Pituitary and placental gonadotrophins and sex steroids in the human and sub-human primate fetus. Clinics Endocrinol Metab 1978; 7(3): 487–511.
  4. Hughes IA. Minireview: Sex differentiation. Endocrinology 2001; 142(8): 3281–3287.
  5. MacLaughlin DT, Donahoe PK. Sex determination and differentiation. N Engl J Med 2004; 350(4): 367–378.
  6. Takagi S, Yoshida T, Tsubata K, et al. Sex differences in fetal gonadotropins and androgens. J Steroid Biochem 1977; 8(5): 609–620.
  7. Virtanen HE, Cortes D, Rajpert-De Meyts E, et al. Development and descent of the testis in relation to cryptorchidism. Acta Pædiatrica 2007; 96(5): 622–627. 
  8. Baker TG, Scrimgeour JB. Development of the gonad in normal and anencephalic human fetuses. J Reprod Fertil 1980; 60(1): 193–199.
  9. Kuiri-Hänninen T, Sankilampi U, Dunkel L. Activation of the hypothalamic- -pituitary-gonadal axis in infancy: minipuberty. Horm Res Paediatr 2014; 82(2): 73–80.
  10. Lanciotti L, Cofini M, Leonardi A, et al. Up-to-date review about minipuberty and overview on hypothalamic-pituitary-gonadal axis activation in fetal and neonatal life. Front Endocrinol (Lausanne) 2018; 23(9): 410.
  11. Bizzarri C, Cappa M. Ontogeny of hypothalamus-pituitary gonadal axis and minipuberty: an ongoing debate? Front Endocrinol 2020; 11: 187.
  12. Johannsen TH, Main KM, Ljubicic ML, et al. Sex differences in reproductive hormones during mini-puberty in infants with normal and disordered sex development. J Clin Endocrinol Metab 2018; 103(8): 3028– 3037.
  13. Busch AS, Ljubicic ML, Upners EN, et al. Dynamic changes of reproductive hormones in male minipuberty: temporal dissociation of Leydig and Sertoli cell activity. J Clin Endocrinol Metab 2022; 107(6): 1560– 1568.
  14. Kuijper EA, van Kooten J, Verbeke JI, et al. Ultrasonographically measured testicular volumes in 0-to 6-year-old boys. Hum Reprod 2008; 23(4): 792–796.
  15. Boas M, Boisen KA, Virtanen HE, et al. Postnatal penile length and growth rate correlate to serum testosterone levels: a longitudinal study of 1962 normal boys. Eur J Endocrinol 2006; 154(1): 125–129.
  16. Henriksen LS, Petersen JH, Skakkebæk NE, et al. Serum testosterone levels in 3-month-old boys predict their semen quality as young adults. J Clin Endocrinol Metab 2022; 107(7): 1965–1975.
  17. Hines M, Spence DR, Kung KTF, et al. The early postnatal period, mini- -puberty, provides a window on the role of testosterone in human neurobehavioural development. Curr Opin Neurobiol 2016; 38: 69–73.
  18. Chin HB, Baird DD, Kaplan SL, et al. Characterization of ovarian development in girls from birth to 9 months. Paediatr Perinat Epidemiol 2021; 38: 75–82.
  19. Kuiri-Hänninen T, Haanpää M, Turpeinen U, et al. Postnatal ovarian activation has effects in estrogen target tissues in infant girls. J Clin Endocrinol Metab 2013; 98(12): 4709–4716.
  20. Kuiri-Hänninen T, Haanpää M, Turpeinen U, et al. Transient postnatal secretion of androgen hormones is associated with acne and sebaceous gland hypertrophy in early infancy. J Clin Endocrinol Metab 2013; 98(1): 199– 206.
  21. Kuiri-Hänninen T, Seuri R, Tyrväinen E, et al. Increased activity of the hypothalamic- Pituitary-Testicular axis in infancy results in increased androgen action in premature boys. J Clin Endocrinol Metab 2011; 96(1): 98–105.
  22. Kuiri-Hänninen T, Kallio S, Seuri R, et al. Postnatal developmental changes in the pituitary-ovarian axis in preterm and term infant girls. J Clin Endocrinol Metab 2011; 96(11): 3432–3439.
  23. Sedin G, Bergquist C, Lindgren PG. Ovarian hyperstimulation syndrome in preterm infants. Pediatr Res 1985; 19(6): 548–552.
  24. Pepe G, Calafiore M, Velletri MR, et al. Minipuberty in born small for gestational age infants: A case control prospective pilot study. Endocrine 2022; 76(2): 465–473.
  25. Ibáñez L, Valls C, Cols M, et al. Hypersecretion of FSH in infant boys and girls born small for gestational age. J Clin Endocrinol Metab 2002; 87(5):1986–1988.
  26. Nagai S, Kawai M, Myowa-Yamakoshi M, et al. Gonadotropin levels in urine during early postnatal period in small for gestational age preterm male infants with fetal growth restriction. J Perinatol 2017; 37(7): 843–847.
  27. Deng X, Li W, Luo Y, et al. Association between small fetuses and puberty timing: a systematic review and meta‐analysis. Int J Environ Res Public Health 2017; 14(11): 1377–1388.
  28. Tack LJW, van der Straaten S, Riedl S, et al. Growth, puberty and testicular function in boys born small for gestational age with a nonspecific disorder of sex development. Clin Endocrinol 2022; 96(2): 165–174.
  29. Renault CH, Højrup Ch, Aksglaede L, et al. Minipuberty of human infancy „A window of opportunity to evaluate hypogonadism and differences of sex development?“ Ann Pediat Endocrinol Metab 2020; 25(2): 84–91.
  30. Quinton R, Mamoojee Y, Jayasena CN, et al. Society for endocrinology UK guidance on the evaluation of suspected disorders of sexual development: emphasizing the opportunity to predict adolescent pubertal failure through a neonatal diagnosis of absent minipuberty. Clin Endocrinol 2016; 86(2): 305–306.
  31. Grumbach MM. A window of opportunity: the diagnosis of gonadotropin deficiency in the male infant. J Clin Endocrinol Metab 2005; 90(5): 3122–3127.
  32. Swee DS, Quinton R. Congenital hypogonadotrophic hypogonadism: minipuberty and the case for neonatal diagnosis. Front Endocrinol (Lausanne) 2019; 10: 97. doi: 10.3389/fendo.2019.00097
  33. Ljubicic ML, Busch AS, Upners EN, et al. A biphasic pattern of reproductive hormones in healthy female infants: The COPENHAGEN Minipuberty Study. J Clin Endocrinol Metab 2022; 107(9): 2598–2605.
  34. Papadimitriop DT, Chrysis D, Nyktari G, et al. Replacement of male mini- -puberty. J Endocr Society 2019; 3(7): 1275–1282.
  35. Bougnères P, François M, Pantalone L, et al. Effects of an early postnatal treatment of hypogonadotropic hypogonadism with a continuous subcutaneous infusion of recombinant follicle-stimulating hormone and luteinizing hormone. J Clin Endocrinol Metab 2008; 93(6): 2202–2205.
  36. Davis SM, Kaar JL, Ringham BM, et al. Sex differences in infant body composition emerge in the first 5 months of life. J Pediatr Endocrinol Metab 2019; 32(11): 1235–1239.
  37. Kiviranta P, Kuiri-Hänninen T, Saari A, et al. Transient postnatal gonadal activation and growth velocity in infancy. Pediatrics 2016; 138(1): e20153561.
  38. Varimo T, Hero M, Laitinen EM, et al. Childhood growth in boys with congenital hypogonadotropic hypogonadism. Pediatr Res 2016; 79(5): 705–709.
  39. Lucaccioni L, Trevisani V, Boncompagni A, et al. Minipuberty: looking back to understand moving forward. Front Pediat 2021; 18(8): 612235. doi: 10.3389/fped.2020.612235
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