Risk factors and preventive strategies for precocious puberty: a narrative review

Precocious puberty (PP) is a common pediatric endocrine disorder with rising global incidence, significantly compromising children's quality of life and long-term health. Current therapeutic options remain limited in applicability, leaving many patients inadequately controlled. Prevention targeting known risk factors is substantially more cost-effective than post-diagnosis treatment; however, the available evidence on PP risk factors remains fragmented. This review systematically synthesizes the risk factors for PP across seven age stages-preconception period, fetal period, infancy, toddlerhood, preschool age, school age, and adolescence-and eight domains: genetic predisposition and family history, maternal conditions and prenatal factors, delivery mode and early feeding patterns, dietary behaviors and nutritional status, individual lifestyle habits, family/school/community environments, early clinical signs and indicators, and pre-existing and idiopathic medical conditions. Corresponding preventive strategies, including optimizing parental reproductive health, promoting balanced nutrition, physical activity, and psychosocial well-being, and fostering multi-sector collaboration, are briefly discussed. This review aims to raise awareness of PP risk factors and facilitate the implementation of preventive strategies.