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Comparison of central precocious puberty frequency before and during COVID-19: a systematic review and meta-analysis
Jianwei Zhang1, Jinliang Xu1, Xiaoli Tang1
1Shaoxing Maternity and Child Health Care Hospital, Shaoxing, 312000, China.
Insights
Central precocious puberty (CPP) significantly increased during the COVID-19 pandemic. Further research is needed to understand the factors contributing to this rise in early puberty.
Area of Science:
- Pediatric Endocrinology
- Public Health
- Epidemiology
Background:
- Central precocious puberty (CPP) is a condition where puberty begins unusually early.
- The COVID-19 pandemic has been associated with various health changes in children, necessitating investigation into its impact on endocrine disorders.
Purpose of the Study:
- To assess the prevalence of central precocious puberty (CPP) during the COVID-19 pandemic.
- To compare CPP incidence before and during the pandemic using a systematic review and meta-analysis.
Main Methods:
- A systematic review and meta-analysis were conducted following PRISMA guidelines.
- Searched PubMed, Embase, Web of Science, and WANFANG databases (Jan 2019 - Mar 2023).
- Included studies on children ≤15 years with defined CPP criteria, comparing pre-pandemic and pandemic periods.
Main Results:
- The meta-analysis included 17 studies.
- CPP occurrence was significantly elevated during the COVID-19 pandemic (OR = 2.57; 95% CI, 1.85-3.56).
- A slight, non-significant increase in BMI SDS was observed in CPP patients during the pandemic.
Conclusions:
- CPP frequency significantly increased during the COVID-19 pandemic.
- The findings highlight a potential link between the pandemic and early puberty onset.
- Further large-scale cohort studies are recommended to identify specific pathogenic factors.
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 I2 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.
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