Diagnosis of Central Precocious Puberty Rising During COVID-19 Pandemic

A single-center retrospective analysis of data from an endocrinology clinic in Turkey provides insight into an apparent increase in diagnoses of idiopathic central precocious puberty.

New research from Turkey details a concerning increase in the number of diagnoses of central precocious puberty during the COVID-19 pandemic compared to prepandemic periods.

A single-center analysis of patients presenting to an endocrinology clinic in Turkey, results of the study indicate more than twice as many girls were diagnosed with idiopathic central precocious puberty from April 2020-March 2021 than during the 2 years preceding the pandemic.

“This study’s findings suggest that the number of girls diagnosed with idiopathic central precocious puberty during the 1-year study period during the pandemic was more than double that of any of the previous 3 years” wrote investigators.

Among the multitude of nuances that have accompanied life during the COVID-19 pandemic has been the delays in care and the ripple effect it has caused. This has manifested in the form of regular appointments being cancelled or missed, neglecting to seek care for adverse events, and missed diagnoses. With this in mind, Sezer Acar, MD, and Behzat Ökhan, MD, both of the Division of Pediatric Endocrinology at Dr. Behçet Uz Children’s Education and Research Hospital in Izmir, Turkey, sought to assess how diagnosis of idiopathic central precocious puberty may have differed during the COVID-19 pandemic as compared with periods prior to the pandemic.

To do so, investigators designed their study to compare demographic, anthropometric, and clinical characteristics of idiopathic central precocious puberty patients diagnosed during a one-year period of the COVID-19 pandemic with the characteristics of patients diagnosed during the same period in the previous three-years. Using data from the pediatric endocrinology at Dr. Behçet Uz Children’s Education and Research Hospital, the study compared data from patients diagnosed from April 2020-March 2021 to those diagnosed from April 2017-March 2020.

A total of 124 patients, all girls, received a diagnosis of idiopathic central precocious puberty from April 2017-March 2021. From April 2017-March 2018, 19 patients were diagnosed. From April 2018-March 2019, 22 patients were diagnosed. From April 2019-March 2020, 25 patients were diagnosed. During the pandemic period, 58 patients were diagnosed.

Upon analysis, results suggested age at diagnosis, weight standard deviation score (SDS), height SDS, body mass index (BMI) SDS, Tanner stage, bone age, bone age/chronological age, frequency of rapidly progressive or accelerated puberty, and frequency of obesity were similar among those diagnosed during the pandemic and those diagnosed prior to the pandemic (P <.05).

Investigators point out their findings were in line with a pair of recent studies detailing an increase in the frequency of central precocious puberty and an acceleration of pubertal progression in girls after the start of lockdowns during the COVID-19 pandemic. However, unlike those studies, the current study did not report a significant increase in BMI SDS compared to the prepandemic period, which investigators suggest indicate factors other than increased BMI could play a role in the increased diagnosis.

In their conclusion, investigators noted the need for further studies to understand the impact of the COVID-19 pandemic on diagnosis of central precocious puberty and how other factors associated with the pandemic may have influenced risk of central precocious puberty.

“The results of our single-center retrospective study suggest that during the lockdown imposed due to the COVID-19 pandemic, there was a numerical increase in the diagnosis of idiopathic central precocious puberty in girls. Prospective multicenter studies are needed to confirm the increased incidence of central precocious puberty and to investigate potential contributing factors,” investigators wrote.

This study, “Increased frequency of idiopathic central precocious puberty in girls during the COVID-19 pandemic: preliminary results of a tertiary center study,” was published in the Journal of Pediatric Endocrinology and Metabolism.