Precocious puberty, cases doubled in 2020. The Italian study
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Cases of precocious puberty more than doubled during the lockdown of 2020. The phenomenon is described in an observational study published in theItalian Journal of Pediatrics from a team of endocrinologists of the Bambino Gesù Pediatric Hospital in Rome. (1) The second phase of the research, which has already started, has the objective of expanding the observatory and investigating the causes of the phenomenon.
Precocious puberty from lockdown
Premature puberty it consists of sexual maturation that begins before the age of 8 in girls and before the age of 9 in boys. It falls within the scope of rare diseases, with an incidence of 0,1-0,6% of the population (in Italy from 1 to 6 births per 1000).
The child's body begins to transform into an adult too early, with an acceleration of the development of sexual characteristics and a rapid closure of the bone growth plates.
As a result of this process, children grow quickly in height, but then the peak wears off and as adults they are below average stature. If the diagnosis is made early - before the age of 8 - it is possible to use drugs to slow down puberty.
The increase in cases
The disproportion of numbers in the accesses to the hospital it aroused the attention of the endocrinologists of the Infant Jesus.
In the period March-September 2020 there were 224 patients (215 females and 9 males) who presented an early pubertal or precocious puberty, against 93 (87 females and 6 males) in the same period in 2019.
Premature puberty involves children under the age of 8. In the two-year period under review, the average age for girls stood at 7,51 years and 7,97 for boys in 2019. In 2020, however, the surveys marked an average age of 7,33 years for girls and of 8,14 in males.
The survey it was also extended to the years 2017 and 2018: in the period considered, early or early puberty affected a number between 80 and 90 patients.
The role of the lockdown pandemic
The hypothesis of the researchers is that at the base of the phenomenon there was a combination of coinciding factors during the lockdown.
The interruption face-to-face lessons, afternoon outings for play and sport have drastically reduced the physical activity of children. And at the same time they have upset their diet, weighed down by more caloric meals and after hours.
A role it is also attributed to the prolonged use of computer e tablets, made necessary by distance learning.
Phase 2 of the precocious puberty study
The evidence dictated the need to expand the research, now extended to the Pediatric Endocrinology Centers of Genoa, Cagliari and Naples.
Through interviews telephone calls to patients in 2019 and 2020, data will be collected to be compared with a score specially prepared to evaluate possible predisposing factors.
'During the lockdown, the children underwent changes that affected the normal timing of growth. We have detected this through the accesses to our clinics, but certainly there are cases that escape us. It is a phenomenon whose impact has to be evaluated. It is probable, for example, that the growth trend we are witnessing from year to year could have a significant arrest linked to the phenomenon of rapid puberty ', explains Professor Marco Cappa, head of the Diabetology Unit at the Department of Pediatric Medicine of the Bambino Gesu hospital in Rome and Palidoro and professor of Pediatric Endocrinology at the Roman universities of the Catholic University and La Sapienza.
Marta Strinati
Footnotes
(1) Verzani, M., Bizzarri, C., Chioma, L. et al. Impact of COVID-19 pandemic lockdown on early onset of puberty: experience of an Italian tertiary center. Ital J Pediatr 47, 52 (2021). https://doi.org/10.1186/s13052-021-01015-6
