Wang Yan, Wang Aiping, Kong Lifang, Li Jie, Li Suyue, Liu Yun, Zhang Li, Zhang Ruifang, Ban Caixia, Jiang Yanrui, Sun Wanqi, Song Yuanjin, Jiang Fan
Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Ministry of Education Shanghai Key Laboratory of Children's Environmental Health, Shanghai 200127, China.
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Zhonghua Er Ke Za Zhi. 2014 Jan;52(1):5-10.
The term "premature thelarche" refers to isolated breast development before 8 years of age in female, without any other signs of sexual maturation, while "gynecomastia" is the presence of breast tissue in males. This study aimed to investigate the prevalence of premature thelarche and gynecomastia in Chinese infants and toddlers, identify the potential risk factors, and explore the influence of early breast development on physical growth, mental development and psychomotor development.
A total of 1 510 full term and healthy children at the age of 0-48 months were sampled by stratified cluster random sampling method from 8 provinces from 2011-2012. Weight, height and breast development were assessed by senior primary pediatricians, while Bayley Scale of Infant Development-I (BSID-I) was used to measure the mental developmental index (MDI) and psychomotor developmental index (PDI) for children aged 2-30 months. Social-demographic Questionnaires were completed by the caregivers.
The combined prevalence of premature thelarche and gynecomastia was 1.6% (23/1 475), girls 2.2% (15/695), boys 1.0% (8/780), all within 2 years of age. The birth weight, feeding patterns in first 4 months, delivery mode, weaning time and social economic status were not significantly associated with the breast development. However, lower father's education level (OR = 3.632, 95%CI = 1.565-8.432) as well as smoking mother (OR = 18.960, 95%CI = 1.590-226.304) were significantly related to breast development even after adjusting for potential confounders. Lower weight (-0.479 ± 0.648 vs. 0.005 ± 0.987, P < 0.05) and height (-0.602 ± 1.042 vs. 0.008 ± 0.986, P < 0.05) Z score were found in breast development group, even after adjusting for age, gender and father' education level. Neither mental development (t = -0.082, P > 0.05) nor psychomotor development (t = 1.054, P > 0.05) was associated with breast development.
We showed a similar prevalence of premature thelarche with the data reported in similar studies reported from other countries. Among the 0-48 months old infants and toddlers, Father's education level and smoking mother were both related to breast development. Breast development was significantly associated with physical growth, but had no correlation with the mental or psychomotor development.
“性早熟乳房发育”指女童8岁前出现孤立性乳房发育，无任何其他性成熟迹象，而“男性乳房发育症”是指男性乳房组织的出现。本研究旨在调查中国婴幼儿中性早熟乳房发育和男性乳房发育症的患病率，确定潜在风险因素，并探讨早期乳房发育对身体生长、智力发育和心理运动发育的影响。
2011年至2012年，采用分层整群随机抽样方法，从8个省份共抽取1510名0至48个月的足月健康儿童。由资深儿科医生评估体重、身高和乳房发育情况，同时使用贝利婴儿发展量表第一版（BSID-I）测量2至30个月儿童的智力发育指数（MDI）和心理运动发育指数（PDI）。照顾者完成社会人口学调查问卷。
性早熟乳房发育和男性乳房发育症的合并患病率为1.6%（23/1475），女童为2.2%（15/695），男童为1.0%（8/780），均在2岁以内。出生体重、前4个月的喂养方式、分娩方式、断奶时间和社会经济状况与乳房发育无显著关联。然而，即使在调整潜在混杂因素后，父亲教育水平较低（OR = 3.632，95%CI = 1.565 - 8.432）以及母亲吸烟（OR = 18.960，95%CI = 1.590 - 226.304）与乳房发育显著相关。即使在调整年龄、性别和父亲教育水平后，乳房发育组的体重Z评分（-0.479 ± 0.648 vs. 0.005 ± 0.987，P < 0.05）和身高Z评分（-0.602 ± 1.042 vs. 0.008 ± 0.986，P < 0.05）较低。乳房发育与智力发育（t = -0.082，P > 0.05）和心理运动发育（t = 1.054，P > 0.05）均无关联。
我们显示的性早熟乳房发育患病率与其他国家类似研究报告的数据相似。在0至48个月的婴幼儿中，父亲教育水平和母亲吸烟均与乳房发育有关。乳房发育与身体生长显著相关，但与智力或心理运动发育无相关性。
