ESPE Yearbook of Paediatric Endocrinology

BMC Endocr Disord. 2024 Oct 17;24(1):219. doi: 10.1186/s12902-024-01749-4. PMID: 40015255

Brief Summary: This systematic review and meta-analysis included 17 retrospective studies assessing central precocious puberty (CPP) incidence before and during the COVID-19 pandemic. The pooled analysis revealed a marked increase in CPP diagnoses during the pandemic (OR=2.57; 95% CI=1.85–3.56), with no major difference in clinical features.

During the COVID-19 pandemic, multiple centers reported an increase in CPP diagnoses (1). This meta-analysis combined data from 17 retrospective studies including over 18,000 children from 8 countries, comparing CPP frequency before and during the pandemic. The results confirmed a markedly higher rate of CPP during the pandemic period.

Interestingly, this increase was not accompanied by changes in age at diagnosis, bone age advancement, BMI SDS, or basal LH levels. This suggests that the rise in diagnoses is unlikely to be due to changes in clinical presentation or earlier identification by the parents. The authors discuss various hypotheses, including increased psychosocial distress/isolation (2), or change in habits with a decrease in outdoor activity and increase in exposure to electronic devices.

In conclusion, there was a marked elevation in CPP frequency throughout the COVID-19 pandemic. While causality cannot be established from retrospective data, these findings underscore the importance of investigating modifiable environmental and behavioral factors influencing pubertal timing. It remains to be determined whether those trends have since reversed or are continuing.

References: 1. Prosperi, S, Chiarelli, F. Early and precocious puberty during the COVID-19 pandemic. Front Endocrinol (Lausanne). 2023;13:1107911. https://doi.org/10.3389/fendo.2022.1107911.2. Ruttle PL, Shirtcliff EA, Armstrong JM, et al. Neuroendocrine coupling across adolescence and the longitudinal influence of early life stress. Dev Psychobiol. 2015;57:688–704. https://doi.org/10.1002/dev.21138.3. Sørensen K, Mouritsen A, Aksglaede L, et al. Recent secular trends in pubertal timing: implications for evaluation and diagnosis of precocious puberty. Horm Res Paediatr. 2012;77:137–45. https://doi.org/10.1159/00033 6325.4. L Z, D Z, Y S. Adverse childhood experiences and early pubertal timing among girls: a meta-analysis. Int J Environmen Res Public Health. 2019;16. https://doi.org/10.3390/ijerp h1616 2887.