Clinical Outcomes and Quality of Life in Children with Central Precocious Puberty: A Pragmatic Analysis.

OBJECTIVES

Variable anthropometric and pubertal outcomes are reported in children with central precocious puberty (CPP) based on treatment choices and practices. We aimed to measure growth and pubertal progression in these children and associate with quality of life in relation to therapy received.

METHODS

This observational study enrolled children with CPP who were receiving/had received gonadotropin releasing hormone analog (GnRHa). The baseline and follow-up clinical details were recorded. Quality of life was assessed using PedsQL 4.0 at the last follow up visit.

RESULTS

Twenty-three children (21girls, 2 boys) with CPP, having a median (IQR) age of 6.75 (5.23, 8.25) years were enrolled. The mean (SD) height SDS was 0.45 (1.20) and BMI-SDS 0.65 (1.06). The median (IQR) follow-up duration was 4.4 (2.5-5.1) years. Twelve children completed their treatment and progressed through puberty normally.Mean bone age/chronological age (BA/CA) ratio decreased from baseline 1.46 to 1.23 at follow-up,  < 0.001. A significant negative correlation was seen between age of start of GnRH therapy and growth velocity on follow-up ( = - 0.598;  = 0.003). The mean (SD) PedsQL scores for total, psychosocial and physical health were 59.02 (22.76), 58.41 (22.83), and 60.73 (25.56), respectively, with lower scores in shorter, older and post-menarcheal girls ( > 0.05).

CONCLUSION

Our study found favorable anthropometric outcomes with resumption of normal puberty after completion of GnRH therapy. The quality of life outcomes were favorable with early and adequate GnRH therapy.