Early onset of puberty during COVID-19 pandemic lockdown: experience from two Pediatric Endocrinology Italian Centers

Martina Goffredo; Alba Pilotta; Ilaria Parissenti; Concetta Forino; Cesare Tomasi; Paolo Goffredo; Fabio Buzi; Raffaele Badolato

doi:10.1515/jpem-2022-0492

Article

Early onset of puberty during COVID-19 pandemic lockdown: experience from two Pediatric Endocrinology Italian Centers

Martina Goffredo , Alba Pilotta , Ilaria Parissenti , Concetta Forino , Cesare Tomasi , Paolo Goffredo , Fabio Buzi and Raffaele Badolato

Published/Copyright: January 6, 2023

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 36 Issue 3

Abstract

Objectives

During COVID-19 pandemic lockdown, reports of evaluations for suspected precocious puberty significantly raised. We aimed to assess the increase of precocious puberty in patients referred to Pediatric Endocrinology Units of Brescia (Italy), to determine clinical characteristics of patients undergoing a GnRH stimulation test before and during lockdown and evaluate the role of environmental factors in pubertal development.

Methods

Clinical and biochemical data of patients undergoing GnRH stimulation test were collected and stratified in two groups: March 2019 – February 2020 (Period 1) and March 2020 – February 2021 (Period 2).

Results

A total number of 391 evaluations for suspected precocious puberty were identified in the two study periods: 183 (46.8%) first visits during Period 1, and 208 (53.2%) in Period 2. Sixty-one patients underwent a GnRH stimulation test (4.1% of first consultations) before the SARS-CoV2 pandemic, and 93 children (8.7%) after the lockdown. Thirty-four new diagnoses of central precocious puberty were registered during Period 1 (2.3%), vs. 45 new cases (4.2%) in Period 2. During lockdown patients evaluated for suspected precocious puberty underwent a stimulation test at younger age than those evaluated before pandemic (median age of 8.2 years vs. 8.4, p=0.04). In Period 2, children showed a median bone age advancement of 0.61 years vs. 1.06 of Period 1 (p=0.03).

Conclusions

During the COVID-19 pandemic, we observed an increased proportion of consultations for suspected precocious puberty. These children showed lower bone age advancement than observed in pre-lockdown suggesting the influence of pandemic-related lifestyle changes on pubertal development.

Keywords: central precocious puberty; COVID-19; environmental factors

Corresponding author: Martina Goffredo, MD, Department of Pediatrics, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy, Phone: +39 3331977602, E-mail: goffredo.martina@gmail.com

Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The local Institutional Review Board deemed the study exempt from review.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/jpem-2022-0492).

Received: 2022-09-26

Accepted: 2022-12-23

Published Online: 2023-01-06

Published in Print: 2023-03-28

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Keywords for this article

central precocious puberty; COVID-19; environmental factors