Maternal Factors During Pregnancy and Pubertal Timing in Offspring: A Systematic Review of the Literature

This systematic review aims to identify, assess the quality of, and synthesize evidence on nongenetic maternal factors, such as psychological factors, lifestyle, nutrition, and endocrine conditions that may be associated with pubertal timing in male and female offspring.

The search was conducted in Medline, Embase, PsycInfo and Web of Science. The reference lists of retrieved articles were checked to avoid missing relevant studies. There were no restrictions on publication year or language. The quality of the studies was assessed using the Newcastle-Ottawa Scale. This review has been registered on PROSPERO (CRD42023394102). A best-evidence approach was applied to qualitatively summarize the findings and draw conclusions on the level of evidence.

The search yielded 4199 studies, of which 73 were included in this systematic review. In both boys and girls, there is strong evidence of a positive association between maternal gestational weight gain and an earlier pubertal timing, while no association was found with maternal substance use, thyroid dysfunction, or gestational hypertension. In addition, there is insufficient evidence of an association with maternal psychological factors, smoking, diet, physical activity, prepregnancy weight/body mass index, diabetes, menstruation-related disorders, and steroid medication use.

This review provides a comprehensive overview of the quality and consistency of existing evidence regarding maternal factors during pregnancy that may be associated with the pubertal timing in their offspring. This review may serve as an orientation for future research initiatives, with a particular focus on exploring these associations among male offspring and in low- and middle-income countries.