Do Most 7- to 8-Year-Old Girls with Early Puberty Require Extensive Investigation and Treatment?

STUDY

OBJECTIVE

To investigate the etiology, progression, and treatment of precocious puberty in 7- to 8-year-old girls with breast development. Additionally, we evaluated the value of diagnostic tests in differentiating rapidly progressive precocious puberty (RP-PP) and slowly progressive precocious puberty (SP-PP) in these girls.

DESIGN

Ambispective cohort study.

SETTING

Single-center, pediatric endocrinology unit.

PARTICIPANTS

Girls with breast development between the ages of 7 and 8 years and assessed between July 2016 and July 2018.

INTERVENTIONS: Collected of clinical data and followed-up for 2 to 3 years. Girls were divided into RP-PP and SP-PP groups.

MAIN OUTCOME MEASURES: Described the etiology, rate of progression of puberty, and proportion intervened and compared the results of auxiliary examinations between the groups.

RESULTS

A total of 212 girls were enrolled, of which 211 (99.53%) were diagnosed with central precocious puberty (CPP) and 1 with peripheral precocious puberty (PPP). Hypophysis magnetic resonance imaging revealed that none had pathological brain lesions requiring surgical intervention. A total of 95 girls (44.81%) developed RP-PP, and 117 girls (55.19%) developed SP-PP. A total of 31 girls (14.62%) with RP-PP received treatment due to deteriorated predicting adult height. As compared with the SP-PP group, the RP-PP group showed more advanced bone age (BA), a higher level of basal luteinizing hormone (LH), and larger ovarian volume and uterine volumes. Receiver operating characteristic analyses revealed that BA was the best at identifying girls with RP-PP.

CONCLUSION

The majority of girls with breast development between the ages of 7-8 years do not need treatment. BA is a useful preliminary test for identifying girls with RP-PP who are more likely to require treatment.