Fanaki Maria, Michala Lina, Nazari Ervin, Daskalakis George
First Department of Obstetrics and Gynecology, 'Alexandra' General Hospital, National and Kapodistrian University of Athens, Athens, GRC.
First Surgery Clinic, Korgialeneio-Mpenakeio Hospital, Athens, GRC.
Cureus. 2024 Oct 7;16(10):e71002. doi: 10.7759/cureus.71002. eCollection 2024 Oct.
Central precocious puberty (CPP) is a condition where the hypothalamus-pituitary-gonadal axis is activated earlier than normal, leading to premature development of secondary sexual characteristics before eight years of age in girls and nine years of age in boys. The purpose of this study was to critically and systematically evaluate the literature regarding CPP rise during the COVID-19 pandemic. We searched PubMed and Google Scholar for relevant articles using the following MeSH terms: "COVID-19, "precocious puberty," "early puberty," "pediatric endocrinology," and "pandemic effects." We included studies calculating the risk of CPP before and during the COVID-19 pandemic. We excluded studies looking at patients with an identifiable cause for CPP or with peripheral precocious puberty. The primary outcome was the prevalence of central precocious puberty during the pandemic compared to the pre-pandemic period. We analyzed data regarding anthropometric, biochemical, and pelvic ultrasound data between the two groups. Overall, 16 studies with 2.175 subjects were included, of which 1.818 were diagnosed with CPP. There was a rise in the number of new diagnoses of CPP during the COVID-19 pandemic (985 subjects) compared with the pre-pandemic period (833 subjects). The mean age of diagnosis in the first group was 7.42 years versus 7.54 years in the second group. Notably, CPP during the pandemic was associated with a higher body mass index (BMI) compared with the group of the pre-pandemic period (17.50 versus 17.08). The pandemic and lockdowns led to changes in lifestyle habits, social isolation, sleep disturbance, excess screen time, and increased stress levels. We hypothesize that these alterations influenced the increase in CPP frequency.
中枢性性早熟（CPP）是一种下丘脑-垂体-性腺轴比正常情况更早被激活的病症，导致女孩在8岁前、男孩在9岁前出现第二性征过早发育。本研究的目的是批判性地、系统地评估关于COVID-19大流行期间CPP发病率上升的文献。我们使用以下医学主题词（MeSH）在PubMed和谷歌学术上搜索相关文章：“COVID-19”“性早熟”“青春期早熟”“儿科内分泌学”和“大流行的影响”。我们纳入了计算COVID-19大流行之前和期间CPP风险的研究。我们排除了研究有明确CPP病因或外周性早熟患者的研究。主要结果是大流行期间与大流行前相比中枢性性早熟的患病率。我们分析了两组之间关于人体测量学、生化和盆腔超声数据的数据。总体而言，纳入了16项研究，共2175名受试者，其中1818名被诊断为CPP。与大流行前时期（833名受试者）相比，COVID-19大流行期间CPP新诊断病例数有所增加（985名受试者）。第一组的平均诊断年龄为7.42岁，第二组为7.54岁。值得注意的是，与大流行前组相比，大流行期间的CPP与更高的体重指数（BMI）相关（分别为17.50和17.08）。大流行和封锁导致生活习惯改变、社会隔离、睡眠障碍、屏幕时间过长和压力水平增加。我们假设这些改变影响了CPP发病率的增加。
