Groundbreaking research presented at the inaugural Joint Congress of the European Society of Paediatric Endocrinology (ESPE) and the European Society of Endocrinology (ESE), held in Copenhagen in May 2025, sheds new light on the complex interplay between early-life growth and its long-term consequences on pubertal development and adult stature. This comprehensive study, conducted by a team of Swedish researchers, emphasizes that while growth during the first two years of life significantly shapes the trajectory of pubertal growth and ultimate adult height, it appears to exert minimal influence on the timing of puberty itself. These findings pave the way for re-evaluating early child health monitoring strategies and provide a quantifiable basis for predicting aspects of growth that have far-reaching health implications.
The early postnatal period, often referred to as the first 1,000 days—from conception through the first two years after birth—is increasingly recognized as a critical window in developmental biology. Growth patterns within this timeframe have been linked not only to immediate health outcomes but also to susceptibility to chronic disease later in life. Despite the well-documented importance of early growth, prior research has predominantly focused on weight measurements, which benefit from broader availability and frequent clinical recording. However, height—a parameter less frequently analyzed with sufficient granularity—plays a pivotal role in understanding growth dynamics and developmental programming.
In an unprecedented effort to dissect these complex relationships, researchers explored the growth trajectories of nearly 4,700 individuals of Nordic descent from two longitudinal cohorts established in Gothenburg, Sweden, spanning births between 1974 and 1990. By integrating detailed birth records, longitudinal height measurements, and parental height data, the study sought to unravel how early growth phases contribute to later pubertal growth and the attainment of adult height. Such comprehensive data, coupled with advanced mathematical modeling, allowed the team to parse out subtle yet significant effects that earlier studies could not adequately discern.
Central to their methodological innovation was the application of the Quadratic-Exponential-Pubertal-Stop (QEPS) growth model, a sophisticated analytical tool designed to segregate growth into distinct phases: basic growth, early childhood growth, pubertal growth, and the subsequent cessation of growth. The QEPS model’s granular approach provided unprecedented insight into the differential contributions of these stages, revealing that approximately 38% of variation in pubertal growth could be attributed to growth occurring in the first two years of life. In contrast, the magnitude of height gained during puberty accounted for a surprisingly modest 9% of the variation observed in adult height outcomes.
Delving deeper, the study highlighted that early-life factors are paramount not just for pubertal growth but for ultimate adult stature. Quantitatively, nearly 67% of the variability in adult height was linked to early-life growth parameters, with an additional 67% explained by growth throughout childhood. Furthermore, birth size itself accounted for 60% of adult height variation, underscoring the enduring impact of perinatal conditions. Parental height, often regarded as a proxy for genetic potential, explained 37% of the difference in adult height among individuals, reaffirming the complex interplay between inherited traits and environmental influences during early developmental stages.
Remarkably, the timing of puberty—the age at which individuals enter and progress through sexual maturation—did not show a significant relationship with early growth measures. This dissociation suggests that the regulatory mechanisms governing pubertal onset may be predominately influenced by genetic predispositions and environmental exposures beyond infancy. Such findings challenge prevailing assumptions that early postnatal growth uniformly impacts all facets of maturation and highlight the need for focused investigations into the determinants of pubertal timing.
Dr. Carin Skogastierna, the lead investigator from the University of Gothenburg and Sahlgrenska University Hospital, elaborated on the implications of these findings. She emphasized that while early growth strongly predisposes individuals to certain adult phenotypes, pubertal timing remains a multifaceted trait subject to complex regulation. The ability of the QEPS model to differentiate between overlapping growth phases offered novel perspectives that could refine clinical growth assessment and intervention strategies.
Previous literature has consistently linked poor early-life growth with impaired health outcomes, including increased risks for metabolic syndrome, cardiovascular disease, and reduced psychosocial wellbeing. However, the innovative application of the QEPS modeling framework in this study disentangled the interactions of specific growth intervals, illuminating the distinctive contributions of early childhood growth and pubertal growth to adult outcomes. This methodological advancement sets a new standard for future research aiming to decipher growth trajectories with greater precision.
In their ongoing research endeavors, Dr. Skogastierna and her team are expanding the scope of inquiry to investigate how early-life growth patterns correlate with socioeconomic status and long-term health trajectories across the lifespan. This approach acknowledges the multifactorial nature of growth and development, incorporating genetic, environmental, and social determinants of health. Their ultimate goal is to translate these findings into actionable approaches that support early detection of growth anomalies and promote interventions fostering healthier developmental outcomes.
The broader societal implications of this study are profound. If suboptimal growth during infancy is demonstrably linked to diminished wellbeing in adolescence and heightened risk of morbidity and mortality in adulthood, then healthcare investments directed toward infant and early childhood care yield dividends that extend far beyond the early years. Public health policies predicated on these insights could lead to improvements in population health, reduce healthcare burdens, and enhance quality of life across generations.
Moreover, the integration of detailed growth modeling into pediatric endocrinology practice may facilitate personalized growth monitoring and tailored interventions, bridging gaps between genetic predisposition and environmental modulation. The current findings thus represent a meaningful advancement in our understanding of human development and the factors influencing lifelong health trajectories.
The results of this research have been published in the prestigious journal Pediatric Research, offering an accessible platform for clinicians and researchers worldwide to engage with and build upon these novel insights. The study exemplifies the power of interdisciplinary collaboration, combining clinical expertise, large-scale cohort data, and mathematical rigor to tackle enduring questions in growth biology.
As the scientific community awaits further results from ongoing investigations, this foundational work underscores the indispensability of early-life health surveillance. It also encourages a paradigm shift emphasizing not merely survival but optimal developmental outcomes, ensuring that the earliest stages of human life are accorded maximal attention for their enduring influence on health and disease.
Subject of Research: Early-life growth patterns and their influence on pubertal growth, pubertal timing, and adult height.
Article Title: Early Childhood Growth Shapes Pubertal Growth and Adult Stature but Not Pubertal Timing: Insights from a Nordic Cohort Using the QEPS Model
News Publication Date: May 2025
Web References: https://www.nature.com/articles/s41390-025-03939-9
References: Skogastierna, C., et al. (2025). “Quantifying the impact of early growth on puberty and adult height using the QEPS model”. Pediatric Research. https://www.nature.com/articles/s41390-025-03939-9
Image Credits: European Society of Endocrinology
