Differentiating true precocious puberty and puberty variants in consecutive 275 girls: a single center experience

This study aimed to identify clinical features of girls referred to a pediatric endocrinology clinic for suspected precocious puberty, differentiate true precocious puberty from other variants, evaluate treatment status, and identify distinguishing factors between patient groups.

We retrospectively evaluated the records of 275 consecutive girls aged 0-10 years referred for suspected precocious puberty.

Among the patients, 30 (10.9 %) were diagnosed with precocious puberty, 35 (12.7 %) with premature adrenarche, 22 (8 %) with premature thelarche, 33 (12 %) with rapidly progressing early puberty, 108 (39.3 %) with early puberty, and 47 (17.1 %) had a normal diagnosis. Precocious puberty was associated with higher rates of overweight/obesity (p=0.002), advanced bone age (p<0.001), height SD, and mid-parental height SD difference (p<0.001), as well as a history of preterm birth (p=0.041). Patients with rapidly progressing early puberty had mothers with a lower age at menarche (p=0.040). No significant differences were found for being born small for gestational age, maternal polycystic ovary syndrome, screen time, and junk food consumption (p>0.05). Treatment was recommended for 32 patients (11.6 %), including 11 with precocious puberty and 21 with rapidly progressing early puberty.

Most patients referred for early pubertal development are diagnosed with normal puberty or its variants. Assessing preterm birth, early maternal menarche age, and advanced bone age helps identify true precocious puberty and rapidly progressing early puberty, aiding timely treatment.