Cases Of Early Onset Of Puberty Increased During Covid-19 Pandemic: Pune Study

Cases of precocity increased three times during the Covid-19 pandemic. The new study suggests lifestyle changes may have been a cause

During the Covid-19 pandemic, cases of early onset of puberty increased to 5.1 per cent | Representative Photo

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A study conducted in Pune has found that cases of precocity — or early onset of puberty in children — increased three times during the Covid-19 lockdown. The study has been published in the Journal of Pediatric Endocrinology and Metabolism.

Doctors at the Growth and Paediatric Endocrinology Unit, Hirabai Cowasji Jehangir Medical Research Institute, in Pune observed that referrals for precocity had increased during the lockdown, and carried out the study to establish this.

The retrospective study divided the patients into two groups — those who had visited the endocrinology unit before lockdown (September 1, 2018 to February 29, 2020) and those who had visited it during  the lockdown period (March 1, 2020 to September 30, 2021).

Among these patients, the researchers looked at the data for the number of patients who were referred for precocious puberty, and among these, the number who were referred for Idiopathic central precocious puberty.

“Precocious puberty was defined as the onset of physical changes of puberty before 8 years of age in girls and 9 years in boys. Idiopathic central precocious puberty was defined as the appearance of a definite breast bud before 8 years in girls and testicular volume more than 3 mL before 9 years of age in boys, without the presence of any central nervous system defect,” the researchers wrote in the paper.

Findings

The study found that during the lockdown, out of 3,053 patients, 155 (5.1%, and including 146 girls) were referrals for precocity. Before the lockdown, out of 4,208 patients, the number of referrals for precocity was 59 (1.4%, including 54 girls).

The proportion of referrals for idiopathic central precocious puberty (iCPP) too was significantly higher in the lockdown (4.4%; 136 children) as compared to 1% (44 children) before the lockdown, among both genders.

The authors referred to other studies with similar findings, including in Italy and Turkey.

Possible Reasons

The authors suggested that multiple changes during the pandemic could have led to an earlier onset of puberty. “Restriction of outdoor activity, increased screen time, consumption of high calorie foods and binge eating habits resulting in increased obesity may result in an earlier onset and accelerated tempo of puberty,” they wrote.

“A number of other reasons may have contributed to the precocity. Increased use of mobile phones and other electronic devices and decreased sleep leading to lower night time melatonin levels have been postulated to stimulate early onset of puberty,” they added.

The authors also mentioned the possible role of a chemical found in sanitisers. A group of chemicals called endocrine disrupting chemicals (EDC) are known to alter the timing and acceleration of puberty, and one EDC, called triclosan, is often found in various hand sanitisers and soaps, though it has been banned by the US FDA, the study said.

The authors said more studies are required to assess the associations of the lockdown period and precocious puberty.