Differences in Puberty of Girls before and during the COVID-19 Pandemic

Abstract

In the COVID-19 pandemic, there was an increase in consultations for precocious puberty. We aim to analyze differences in female puberty before and during the COVID-19 pandemic. A cross-sectional analytical study was designed at the Pediatric Endocrinology Clinic of the University Hospital of the Federal University of Maranhão in São Luis, Brazil. We included 55 girls with precocious puberty, 22 who started puberty during the pandemic and 33 who started puberty before the pandemic. Clinical, anthropometric, laboratory and imaging variables were compared between groups. Statistics were performed to determine if there was a statistical difference between the groups. Girls with puberty during the pandemic had higher Z-scores for weight (1.08 ± 1.29 versus 0.69 ± 0.83; p = 0.04), lower ovarian volume (1.88 ± 0.95 versus 3.15 ± 2.31; p = 0.01), and smaller differences between thelarche noticed by the parents and the diagnosis (6.63 ± 5.21 versus 12.15 ± 9.96; p = 0.02). The association between precocious puberty during the pandemic with higher Z-scores for weight, lower ovarian volume, and a reduction in the time between the perception of pubertal findings by parents and the diagnosis suggests the influence of the pandemic on the normal time of puberty.

Pandemic and precocious puberty - a Google trends study

“…In the published reports of increased PP during COVID-19, in 2020, the reported cases were relatively disproportionally distributed, with 678 cases in Italy[ 2 - 6 ], 275 in Turkey[ 8 - 10 ], 237 in China[ 11 ], 22 in Brazil[ 12 ] and 155 in India[ 13 ]; Portugal was not included in further analyses (see below for details). In South Korea, with data obtained from the country’s hospital records/healthcare database, 95524 children were diagnosed with PP in 2017 (9.89% boys), increasing over the years to 166645 children in 2021 (19.55% boys).…”

“…The search strategy, honed on the tentative effects of COVID-19 on PP, was as follows: “((precocious AND puberty) OR (early AND puberty)) AND COVID-19”. There were 12 original articles (not case reports), all of which[ 5 - 8 ] reported a rise in PP cases[ 9 - 12 ] during the pandemic[ 13 ]. Additionally, we assessed Google trends local searches for selected terms, in English and local languages, in countries where a rise in PP has been reported in the medical literature (Table 2 ).…”

Early and precocious puberty during the COVID-19 pandemic

“…The main lifestyle changes regarded the reduction of both indoor and outdoor physical activities during the first pandemic wave ( 80 , 81 ). This more sedentary routine, together with the worsening of eating habits, intensified the burden of childhood overweight and obesity.…”

Análisis de la incidencia de pubertad precoz central tratada con análogos de hormona liberadora de gonadotrofina. Impacto de la pandemia por COVID-19

“…A partir de los datos recolectados en cinco centros italianos, 16 se constató que entre 2019 y 2020 hubo un aumento del 122 % en el número de casos derivados por cambios puberales tempranos y también en el de pubertad precoz confirmada; se destaca el incremento ocurrido durante el segundo semestre de 2020. Al reporte inicial, se sumaron recientes publicaciones de trabajos realizados en España, 17 Turquía, 18,19 China 20 y Brasil, 21 que describieron similares aceleraciones del desarrollo puberal y aumento de incidencia de PPCI.…”

“…Esta misma limitación nos dificulta, en algunos casos, la evaluación del ritmo de progreso de la pubertad durante la pandemia en contraposición a otros autores que sugieren aumento de este ritmo. 12,18,21 En conclusión, durante el último lustro hemos evidenciado aumento de incidencia de PPCI, que pareciera haberse acelerado durante la pandemia por COVID-19. El incremento en la exposición a desencadenantes ambientales durante este período podría haber ejercido mayor influencia en niñas con alguna predisposición genética.…”