Screen time and pubertal development: a systematic review and meta-analysis

Several mechanisms have been proposed to explain how screen time may affect pubertal development.

To quantify the association between screen time exposure and timing of pubertal onset in children.

We conducted a systematic review and random-effects meta-analysis of observational studies identified through PubMed, Embase, and the Cochrane Library up to 1 May 2025. Pooled odds ratios (ORs) for early or precocious puberty per additional hour of screen time and for categorical comparisons (≥ 2 vs < 2 h/day) were estimated, along with weighted mean differences (WMDs) in daily screen hours.

Of 1,284 unique records, 10 studies enrolling 97,898 children aged 2-19 years met inclusion criteria, most conducted in China. Each additional hour of screen exposure was associated with higher odds of early pubertal development (OR = 1.35; 95% CI = 1.05-1.73). The comparison of ≥ 2 vs < 2 h/day did not reach significance (1.07; 95% CI = 0.90-1.26). In girls, pooled ORs were 1.07 (95% CI = 0.84-1.37) for early puberty and 1.27 (95% CI = 0.85-1.90) for precocious puberty. Children experiencing early puberty spent on average 0.63 additional screen-hours per day compared with peers (WMD = 0.63 h; 95% CI = 0.24-1.02).

Screen time is associated with pubertal onset in both boys and girls, although substantial heterogeneity and cross-sectional designs limit causal inference. Future longitudinal and experimental studies are needed to clarify underlying mechanisms and inform evidence-based guidelines for healthy pubertal development.