Increased Incidence of Precocious Puberty in Girls During COVID-19 Pandemic: Early Indicator of the Upcoming Childhood Metabolic Syndrome Pandemic?

Itani, Alaa; Hamdan, Aya Abou; Zgheib, Hawraa; Ghandour, Zeina B.; Costanian, Christy; Azar, Ahlam

doi:10.1177/2333794x221134565

Cited by 4 publications

(5 citation statements)

References 28 publications

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“…reported than double incidence of CPP in Turkish girls during the pandemic compared to the previous three-years; no significant increase in BMI SDS compared to the pre-pandemic period was reported ( 112 ), suggesting that factors other than increased BMI played a role in the development of CPP. Similar data have been reported in Korean ( 103 ), Turkish ( 115 , 117 ), Indian ( 116 ), Chinese ( 113 , 121 ), Spanish ( 114 ), Brazilian ( 120 ), Lebanese ( 125 ) and American girls ( 126 ) ( Table 1 ).…”

Section: Precocious Puberty During the Covid-19 Pandemic: Current Dat...supporting

confidence: 86%

“…Worldwide many research groups ( 103 , 112 – 117 , 120 , 121 , 125 , 126 ) have reported similar results. For example, Acar et al.…”

Section: Precocious Puberty During the Covid-19 Pandemic: Current Dat...mentioning

confidence: 67%

“…Interestingly, the authors reported a significant increase in CPP already in 2019 when the pandemic officially started in China and they highlighted that the BMI values of these girls were significantly higher than those in the control group. These data are reported also by the Lebanese group (125). Based on a questionnaire, the Chinese authors identified as high-risk factors for CPP the use of electronic devices for prolonged periods, less exercise time, higher BMI, vitamin D deficiency, frequent use of a night light, frequent use of adult cosmetics, consumption of fried food and processed meat, and exposure to second-hand smoke (113).…”

Section: Precocious Puberty During the Covid-19 Pandemic: Current Dat...mentioning

confidence: 90%

“…This phenomenon appears to be global (4,110,111) with cases of precocious puberty increasing dramatically in every country after lockdown restrictions were lifted (103, 105,108,109,[112][113][114][115][116][117][118][119][120][121][122][123][124][125][126]. The first report of an increase in the number of outpatients with newonset CPP from January to May 2020 was from the Meyer Children's University Hospital in Florence, Italy, which reported a 2 fold increase compared with the same period in previous years.…”

Section: Precocious Puberty During the Covid-19 Pandemic: Current Dat...mentioning

confidence: 99%

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Precocious puberty under stressful conditions: new understanding and insights from the lessons learnt from international adoptions and the COVID-19 pandemic

et al. 2023

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Neuro-biological variations in the timing of sexual maturation within a species are part of an evolved strategy that depend on internal and external environmental conditions. An increased incidence of central precocious puberty (CPP) has been described in both adopted and “covid-19 pandemic” children. Until recently, it was hypothesised that the triggers for CPP in internationally adopted children were likely to be better nutrition, greater environmental stability, and improved psychological wellbeing. However, following data collected during and after the coronavirus (COVID-19) global pandemic, other possibilities must be considered. In a society with high levels of child wellbeing, the threat to life presented by an unknown and potentially serious disease and the stressful environment created by lockdowns and other public health measures could trigger earlier pubertal maturation as an evolutionary response to favour early reproduction. The main driver for increased rates of precocious and rapidly progressive puberty during the pandemic could have been the environment of “fear and stress” in schools and households. In many children, CPP may have been triggered by the psychological effects of living without normal social contact, using PPE, being near adults concerned about financial and other issues and the fear of getting ill. The features and time of progression of CPP in children during the pandemic are similar to those observed in adopted children. This review considers the mechanisms regulating puberty with a focus on neurobiological and evolutionary mechanisms, and analyses precocious puberty both during the pandemic and in internationally adopted children searching for common yet unconsidered factors in an attempt to identify the factors which may have acted as triggers. In particular, we focus on stress as a potential factor in the early activation of the hypothalamic-pituitary-gonadal axis and its correlation with rapid sexual maturation.

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Section: Precocious Puberty During the Covid-19 Pandemic: Current Dat...supporting

confidence: 86%

“…Worldwide many research groups ( 103 , 112 – 117 , 120 , 121 , 125 , 126 ) have reported similar results. For example, Acar et al.…”

Section: Precocious Puberty During the Covid-19 Pandemic: Current Dat...mentioning

confidence: 67%

Section: Precocious Puberty During the Covid-19 Pandemic: Current Dat...mentioning

confidence: 90%

Section: Precocious Puberty During the Covid-19 Pandemic: Current Dat...mentioning

confidence: 99%

See 2 more Smart Citations

Precocious puberty under stressful conditions: new understanding and insights from the lessons learnt from international adoptions and the COVID-19 pandemic

et al. 2023

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“…A growing body of evidence suggests a possible increased incidence of PP in girls during the COVID-19 pandemic because of multiple potential causes [ 1 , 2 , 11 , 3-10 ]. Children, adolescents, and adults became less physically active and rates of overweight and obesity, as well as stress, increased during the pandemic [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Precocious Puberty Diagnoses Spike, COVID-19 Pandemic, and Body Mass Index: Findings From a 4-year Study

Fava,

Pepino,

Tosto

et al. 2023

Journal of the Endocrine Society

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Context Since the COVID-19 outbreak, the number of girls with suspected precocious puberty has increased. Objective To compare the incidence of idiopathic central precocious puberty (ICPP) during COVID-19 with that of the previous 4 years. Methods Anthropometric, biochemical, and radiological parameters were collected between January 2016 and June 2021 from 133 girls who met the Rapidly Progressive ICPP criteria (RP-ICPP). Results We found a higher incidence of RP-ICPP between March 2020 and June 2021 (group 2) compared with January 2016 through March 2020 (group 1) (53.5% vs 41.1%); 2021 showed the highest annual incidence (P < .05). Group 1 and group 2 differed in age at diagnosis (7.96 ± 0.71 vs 7.61 ± 0.94; P < .05), mean Tanner stage (2.86 ± 0.51 vs 2.64 ± 0; P < .05), and in the time between the appearance of thelarche and diagnosis (0.93 ± 0.75 vs 0.71 ± 0.62 years, P < .05). There was an increase in the number of girls aged <8 years in group 2 and a significantly higher number of girls aged >8 years was found in group 1 (42 in group 1 vs 20 in group 2, P < 0.05). Overall body mass index SD score showed higher values in group 2 (1.01 ± 1.23 vs 0.69 ± 1.15; P = .18), which spent an average of 1.94 ± 1.81 hours per day using electronic devices; 88.5% of this group stopped any physical activity. Conclusions A spike in new diagnoses of idiopathic (1.79-fold higher) and RP-CPP coincided with the COVID-19 pandemic. The incidence of RP-ICPP was 1.3-fold higher during COVID-19 with a trend toward an increase in body mass index SD score. The expanding use of digital devices and the reduction of daily physical activity represent possible risk factors.

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Comparison of central precocious puberty frequency before and during COVID-19: a systematic review and meta-analysis

Zhang,

Xu,

Tang

et al. 2024

BMC Endocr Disord

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Objective The current systematic review and meta-analysis assessed the prevalence of central precocious puberty (CPP) throughout the novel coronavirus disease 2019 (COVID-19) pandemic. Design A systematic review and meta-analysis were carried out following the principles outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, 2020). Data sources PubMed, Embase, Web of Science, and WANFANG databases were searched from January 1, 2019, to March 30, 2023. Eligibility criteria for selecting studies (1) children and adolescents ≤ 15 years; (2) studies with the outcome of frequency of central precocious puberty, measured prior to and throughout the COVID-19 pandemic; (3) a novel CPP diagnosis was created depending on all of the following criteria: girls with a chronological age < 8 years and boys with a chronological age < 9 years at the onset of symptoms, basal luteinizing hormone (LH) levels > 0.3 UI/L, and/or GnRH-stimulated peak LH levels > 5 IU/L. Data extraction and synthesis The process of extracting data and evaluating the likelihood of bias was carried out by two independent reviewers. The data were pooled employing the generic inverse-variance method and presented as mean differences (MDs) with 95% CIs. The evaluation of heterogeneity was conducted employing the Cochran Q statistic, and the degree of heterogeneity was measured employing the I 2 statistic. Results This meta-analysis included 17 studies. In contrast to the same period prior to the COVID-19 pandemic, the occurrence of CPP elevated (OR = 2.57; 95% CI, 1.85–3.56). Moreover, body mass index standard deviation score (BMI SDS) differences between CPP patients prior to COVID-19 and throughout the pandemic follow-up was 0.12 (95% CI − 0.01 to 0.25 P = 0.06). Conclusion Overall, CPP frequency significantly elevated throughout the COVID-19 pandemic. Given the restricted number of cohort investigations in this meta-analysis, additional research may be conducted on larger groups of children in order to establish a correlation between the observed rise in precocious puberty and specific pathogenic factors. Supplementary Information The online version contains supplementary material available at 10.1186/s12902-024-01749-4.

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Increased Incidence of Precocious Puberty in Girls During COVID-19 Pandemic: Early Indicator of the Upcoming Childhood Metabolic Syndrome Pandemic?

Cited by 4 publications

References 28 publications

Precocious puberty under stressful conditions: new understanding and insights from the lessons learnt from international adoptions and the COVID-19 pandemic

Precocious puberty under stressful conditions: new understanding and insights from the lessons learnt from international adoptions and the COVID-19 pandemic

Precocious Puberty Diagnoses Spike, COVID-19 Pandemic, and Body Mass Index: Findings From a 4-year Study

Comparison of central precocious puberty frequency before and during COVID-19: a systematic review and meta-analysis

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