Early Puberty In Girls Research Articles

Girls should be Girls: The Impact of Child Marriage on Human Development

Child marriage is a violation of Human Rights and an impediment to social and economic development, it is strongly rooted in gender inequality. In Brazil, this practice has a predominantly informal and consensual quality, they often involve adult men married to girls in early puberty. The objective of this study is to synthesize the literature on the impact of child marriage on the most diverse indicators of human development - such as education, labor market, health, fertility, violence and female empowerment. In summary, the literature reveals that child marriage has a negative impact on these indicators, and this corroborates the urge to eliminate this phenomenon, which will ensure women’s right to a full economic and social life.

Early life household intactness and timing of pubertal onset in girls: a prospective cohort study

BackgroundGirls who experience early-life familial stress may have heightened risk of early puberty, which has adverse implications for adolescent and adult health. We assessed the association between household intactness and pubertal onset using a racially/ethnically diverse cohort of girls from Northern California.MethodsA prospective cohort study of 26,044 girls born in 2003-10. Girls living with both parents from birth up to 6 years were considered to come from “intact” households while others constituted “non-intact” households. Pubertal development was measured using pediatrician-assessed Tanner staging for breast and pubic hair. Pubertal onset was defined as the transition from Tanner Stage 1 to 2+ for breast (thelarche) and pubic hair (pubarche). Menarche data was collected from routine well-child questionnaires. Weibull regression models accommodating left, right, and interval censoring were used to determine risk of earlier thelarche and pubarche, and logistic regressions were used to assess the risk of early menarche (age < 12).ResultsGirls exposed to non-intact households before age 2 years were at increased risk for earlier thelarche and pubarche with significant effect modification by race/ethnicity, compared with girls from intact households. The associations were strongest among Black girls (adjusted hazard ratio [HR]: 1.60, 95% confidence interval [CI]: 1.29,1.98; HR: 1.42, 95%CI: 1.15,1.77 for thelarche and pubarche, respectively). There were no significant associations among Asian/Pacific Islanders. Girls who lived in non-intact households before age 2 years were also at increased risk for earlier menarche, but without race/ethnic interaction. Adjustment for prepubertal obesity did not change these associations. Associations between living in non-intact households after age 2 years and early puberty were weaker but still significant.ConclusionsExposure to a non-intact household early in life may increase the risk of early puberty in girls. Future psychosocial interventions focused on improving family cohesiveness and efforts to reduce childhood stress among families that are non-intact may mitigate these negative associations, thereby preventing future adverse health effects of early puberty and health disparities.

Prepubertal Internalizing Symptoms and Timing of Puberty Onset in Girls

Stressful environments have been associated with earlier menarche. We hypothesized that anxiety, and possibly other internalizing symptoms, are also associated with earlier puberty in girls. The Lessons in Epidemiology and Genetics of Adult Cancer From Youth (LEGACY) Girls Study (2011-2016) included 1,040 girls aged 6-13 years at recruitment whose growth and development were assessed every 6 months. Prepubertal maternal reports of daughter's internalizing symptoms were available for breast onset (n=447), pubic hair onset (n=456), and menarche (n=681). Using Cox proportional hazard regression, we estimated prospective hazard ratios and 95% confidence intervals for the relationship between 1 standard deviation of the percentiles of prepubertal anxiety, depression, and somatization symptoms and the timing of each pubertal outcome. Multivariable models included age, race/ethnicity, study center, maternal education, body mass index percentile, and family history of breast cancer. Additional models included maternal self-reported anxiety. A 1-standard deviation increase in maternally reported anxiety in girls at baseline was associated with earlier subsequent onset of breast (hazard ratio (HR)=1.22, 95% confidence interval (CI): 1.09, 1.36) and pubic hair (HR=1.15, 95% CI: 1.01, 1.30) development, but not menarche (HR=0.94, 95% CI: 0.83, 1.07). The association of anxiety with earlier breast development persisted after adjustment for maternal anxiety. Increased anxiety in young girls may indicate risk for earlier pubertal onset.

Early and delayed puberty among Iranian children with obesity

It has been hypothesized that puberty onset is disturbed as the children gain more weight. This study aimed to investigate the prevalence and risk factors of the puberty disturbances among children with obesity in Tehran, Iran. This study was performed as a cross-sectional study, investigating 168 children with obesity from Tehran, Iran, from March 2018 to February 2019. BMI percentile more than 95% was considered as the inclusion criteria. Seventy-eight (46.4%) of the assessed children were females. The mean weight, height, BMI were 89.65 (±11.01) kg, 169.88 (±8.32) centimeters and 31.13(±3.8) kg/m2, respectively. There was no difference between males and females regarding the early puberty (P=0.098), but delayed puberty was significantly higher among males (P=0.029). Our results indicated higher birth weight is associated with earlier onset of obesity in children (P=0.044). Our study demonstrated no association between obesity and early puberty in girls; however, boys with obesity had delayed puberty. We also found higher birth weight is associated with earlier onset of obesity, putting light on the importance of preventive interventions.

SUN-100 Mice Lacking Paternally Expressed DLK1 Reach Puberty at a Lower Body Weight Than Littermate Controls

Body fat content along with a variety of genetic, environmental and psychosocial factors are responsible for the development and maintenance of reproductive function, especially in females. Epidemiologic studies indicate a relationship between increased body mass index and earlier puberty in girls. In contrast, a significant delay in puberty and menarche is seen in girls who are very physically active and have markedly diminished body fat. This link between reproduction and metabolism was reinforced with the recent report of loss-of-function mutations in the Delta-like homolog 1 (DLK1) gene in girls with central precocious puberty (CPP) and increased body fat. DLK1 is a paternally expressed gene located on chromosome 14q32.2 in a locus associated with Temple syndrome (TS), an imprinting disorder caused mainly by maternal parental disomy (mUPD). Dlk1 knockout mice display pre- and postnatal growth retardation, a phenotype that overlaps with human mUPD14. However, precocious puberty, a common finding associated with TS, was not carefully characterized in these mice. We used a Dlk1 deficient mouse model to determine the effects of Dlk1 on pubertal maturation. We confirmed by RT-qPCR that Dlk1 mRNA was undetectable in the mediobasal hypothalamus, where kisspeptin and other regulators of puberty are expressed, of Dlk+/p- mice (which inherited the mutant allele from their father) whereas it was present in Dlk+/+ mice. As reported previously, body weight was significantly lower in juvenile male and female Dlk+/p- mice, compared to wild-type littermate controls. Interestingly, mutant and control female mice achieved vaginal opening, a marker of puberty onset, at a similar age (Dlk+/p-: 29.8 ± 1.5 days, n=11 vs. Dlk+/+: 29.1 ± 0.7 days, n=15, p=0.6) despite a considerably lower body weight in the Dlk1 deficient mice at the time of vaginal opening (Dlk+/p-: 10.1 ± 0.8 g vs. Dlk+/+: 14.3 ± 0.3 g, p<0.0001). Similarly, in the Dlk+/p- males, preputial separation occurred at a lower body weight than in controls (Dlk+/p-: 12.4 ± 0.3 g, n=9 vs. Dlk+/+: 14.1 ± 0.2 g, n=19, p<0.0001). We hypothesize that the lack of Dlk1 at the hypothalamic level may be attenuating the effect of the low body weight on determining pubertal onset. These findings suggest that DLK1 is an important link between body weight and pubertal development in mice, as has been shown in humans.

Association of Polymorphisms in the Kisspeptin/GPR54 Pathway Genes With Risk of Early Puberty in Chinese Girls.

This case control study was designed to investigate the association between mutation of 10 single nucleotide polymorphism (SNP) loci (rs1132506, rs5780218, rs192636495, rs4889, rs184749, rs12985070, rs708910, rs932491, rs8074995, and rs2306877) in all 5 genes (KISS1, GPR54, PLCB1, PRKCA, and ITPR1) in the kisspeptin/GPR54 pathway and the risk of early puberty in Chinese Han girls. A total of 314 pairs of early puberty girls on their first visit to hospital and age-matched controls (± 3 months) were recruited. The genotypes of each SNP were determined and the effect of loci variation on early puberty was investigated. rs5780218 was significantly associated with early puberty in additive, dominant, and recessive models of inheritance after adjusting for confounding factors (Pr < .05). After stratification, rs5780218 variation (odds ratio [OR], 1.650, 95% confidence interval [CI], 1.155-2.355 in additive models and OR, 2.116; 95% CI, 1.187-3.770 in recessive models) increased the risk of central precocious puberty (CPP); mutation in rs708910 (OR, 2.768; 95% CI, 1.305-5.872 in recessive model) had a positive association with the risk of CPP; and rs932491 variation was negatively associated with early and fast puberty (EFP) (OR, 0.309; 95% CI, 0.144-0.661 in additive models and OR, 0.317; 95% CI, 0.141-0.713 in dominant models). Our study suggests that mutation in rs5780218 and rs708910 increases the risk of CPP. rs932491 variation may have a protective effect on the risk of EFP. Further studies in larger populations or with people from different regions are needed to verify our findings.

Chemicals in Personal Care Products Tied to Early Puberty in Girls

Precocious puberty is defined as the onset of menarche before 9 years of age, or the appearance of secondary sex characteristics before 8 years of age. It is associated with many psychosocial disturbances and adverse health outcomes such as: cardiovascular disease, shorter adult stature, an increased risk of type 2 diabetes and breast cancer. There is a general tendency to a progressive decrease in age of reaching puberty, specifically the onset of thelarche and menarche, girls being 10 times more affected than boys. This actual tendency can be explained by the increasing prevalence of childhood obesity and also by increasing environmental exposure to endocrine disruptor chemicals in household and personal care products.Phenols, phthalates, parabens and other compounds, such as polybrominated biphenyls and diethylstilbestrol are associated with precocious onset of puberty in girls, in case of in-utero or peripubertal exposure. These chemicals are frequently found in toothpaste, cosmetics, soups, shampoos, perfumes and other personal care products, interfering with sex hormones and puberty timing. This is why pregnant women should be more aware and avoid products based on these chemicals.

The Effects of Gonadotropin-Releasing Hormone Analog and a Combination of Gonadotropin-Releasing Hormone Analog and Recombinant Human Growth Hormone on Adult Height in Girls with Early Puberty.

Background:Early puberty (EP) is due to the activation of gonadotropin-releasing hormone (GnRH) pulse generator in lower ages; EP may be a potential cause for impairment of adult height, leading to short stature. The aim of this study was to determine the effects of GnRH analog (GnRHa) and GnRHa plus recombinant human growth hormone (rhGH) treatment on final height in healthy girls with EP.Materials and Methods:Fifty EP girls (sexual maturity rating: 2–3) with chronological age (CA) 9.22 ± 0.56 and bone age (BA) 9.74 ± 0.59 years were treated with GnRHa (Triptorelin) at a dose of 100 μg/kg body weight (BW) as intramuscular every 28 days for 2.82 ± 0.57 years; 45 EP girls with CA 9.84 ± 0.57 and BA 10.14 ± 1.02 years were also treated with the same GnRHa plus rhGH (Norditropin) at a dose of 0.1 unit/kg BW daily for 6 days in a week for 2.55 ± 0.6 years. In the control group, 33 EP girls followed for the same period without treatment. Height, weight, and body mass index of girls and parents were assessed. Predicted adult height (PAH) at the start and the end of the study and target height were assessed.Results:PAH at the end of the study in the GnRHa group was not different with untreated girls. PAH at the end of the treatment in GnRHa plus rhGH group was significantly higher than both untreated and GnRHa group. PAH at the end of therapy in GnRHa plus rhGH group was significantly more than their target height.Conclusion:GnRHa therapy has a benefit effect in achievement of target height. Combination therapy with GnRHa plus rhGH increased their PAH more than both untreated and GnRHa groups.

Interaction of hormonal and social environments in understanding body image concerns in adolescent girls

During adolescence, peer approval becomes increasingly important and may be perceived as contingent upon appearance in girls. Concurrently, girls experience hormonal changes, including an increase in progesterone. Progesterone has been implicated in affiliative behavior but inconsistently associated with body image concerns. The current study sought to examine whether progesterone may moderate the association between perceived social pressures to conform to the thin ideal and body image concerns. Secondary analyses were conducted in cross-sectional data from 813 girls in early puberty and beyond (ages 8–16) who completed assessments of the peer environment, body image concerns, and progesterone. Models for mediation and moderation were examined with BMI, age, and menarcheal status as covariates. Belief that popularity was linked to appearance and the experience of weight-related teasing were both positively associated with greater body image concerns, but neither was associated with progesterone once adjusting for covariates. Progesterone significantly interacted with perceived social pressures in predicting body image concerns. At higher progesterone levels, appearance-popularity beliefs and weight-related teasing were more strongly related to body image concerns than they were at lower progesterone levels. Findings support a moderating role for progesterone in the link between social pressures and body image concerns in girls. This study adds to a growing literature examining how girls’ hormonal environments may modulate responses to their social environments. Longitudinal and experimental work is needed to understand temporal relations and mechanisms behind these associations.

Overweight and lower age at menarche: evidence from the Italian HBSC cross-sectional survey

BackgroundA unique standardized national dataset on adolescent girls (21 regions) participating in the Italian Health Behaviour in School-aged Children Study (HBSC) was used to investigate the correlation between body mass index (BMI) and age at menarche.MethodsTwo independent nationally representative survey datasets: one on 15-year-olds (n = 6907, in 21 regions, year 2013/2014) and one on 11-year-olds (n = 10,128, in 20 regions, year 2009/2010) were analysed. The survey instrument was a self-report questionnaire. Median age at menarche and 95% confidence intervals (CIs) were estimated by means of Kaplan–Meier analysis. Hierarchical models were used to assess the relationship between BMI and age at menarche (months). “Region-level obesity” was measured as the prevalence of overweight/obesity (%) in each region.ResultsRegion-level median age at menarche ranged between 12 years/3 months and 13 years/4 months. Region-level prevalence of overweight among 15-year-old girls ranged between 4 and 19%. Age at menarche was inversely associated with individual BMI (unstandardized regression coefficient beta = − 0.70; 95% CI, − 0.84 to − 0.56). Individual- and class-level measures of BMI accounted for 50% of the region-level variance in age at menarche.ConclusionsThe results show that overweight in childhood is in relation with the early puberty in girls. Future surveys may take into account this report to clarify if overweight is the cause or consequence of early menarche.

English

Pyosalpinx and hydrosalpinx are conditions mainly seen in adult women, but also among sexually active adolescents and can bring added hazard to fertility. However these conditions are very rare in childhood, as well as in adolescent girls who are not sexually active. We are presenting two rare cases of young girls in early puberty with hydrosalpinx and pyosalpinx. Both girls had a history of abdomino-pelvic surgery in childhood for congenital bowel anomalies and fecal incontinence. Such cases are good reminders that girls with known abdomino-pelvic anomalies and surgical procedures in childhood need long term follow-up, in particular when entering puberty and maturation. The two cases show how fallopian tubes can be indirectly affected and present in adolescence with serious problems needing surgical procedures and potentially threatening future reproductive system performances.

One-Year Follow-Up of Girls with Precocious Puberty and Their Mothers: Do Psychological Assessments Change over Time or with Treatment?

Background: To determine whether psychological characteristics of girls with variations of early puberty and their mothers change over time and with treatment in girls with central precocious puberty (CPP). Methods: Girls with CPP, premature adrenarche (PA), and early normal puberty (ENP) completed psychological assessments at baseline and after 1 year along with their mothers. All girls with CPP were treated with GnRH analogs. Psychological effects of group and time were examined using 2 × 3 mixed ANOVAs. Results: Sixty-two subjects aged 7.5 ± 1.4 years (range 4.8–10.5) were enrolled, of whom 36 (15 with CPP, 8 with PA, and 13 with ENP) completed 1-year follow-up assessments. Psychological measures were normal in all girls. No significant group differences were found for any measure of girls’ psychological functioning at either time point. However, across all groups there was change over time with a decrease in perceived physical competence (p < 0.001) and an increase in perceived maternal acceptance (p = 0.001). Conclusion: No abnormalities in psychological functioning were found among girls with variations of early puberty, and all groups were in the normal range. Our results are largely reassuring regarding concerns of adverse psychological consequences of early puberty in girls.

Evolution of metabolic alterations 5\xa0Years after early puberty in a cohort of girls predisposed to polycystic ovary syndrome

BackgroundWe and others have observed that young girls predisposed to polycystic ovary syndrome (PCOS) display defective insulin sensitivity, beta-cell function and non-esterified fatty acids (NEFA) suppressibility during early pubertal years, compared to controls. Our objective is to assess whether these differences in glucose and NEFA metabolisms persist after 5 years in late/post-puberty.MethodsWe conducted a prospective cohort study between 2007 and 2015 with 4–6 years of follow-up in an academic institution research center. We compared 8 daughters and sisters of PCOS women (PCOSr) to 8 age-matched girls unrelated to PCOS (±1.5 years). Girls were assessed initially at 8–14 years old and re-assessed after a median follow-up of 5.4 years, at 13–21 years old. Our main measures were a frequently sampled intravenous glucose tolerance test (FSivGTT)-derived insulin sensitivity (IS) and beta-cell function (disposition index, DIFSivGTT); and indices of NEFA suppression during FSivGTT (logn-linear slope of NEFA and T50 of NEFA suppression).ResultsAt follow-up, both PCOSr and controls had similar results: IS = 3.2 vs 3.4 (p = 0.88), DIFSivGTT = 1926 vs 1380 (p = 0.44), logn-linear slope = −0.032 vs −0.032 (p = 0.88) and T50NEFA = 18.1 vs 20.8 min (p = 0.57). IS, DIFSivGTT and NEFA suppressibility were stable in PCOSr after 5 years, but decreased significantly in controls (all p < 0.05).ConclusionsImpaired metabolism observed during early puberty in girls predisposed to PCOS remains stable after 5 years whereas control girls deteriorated their metabolic parameters. Therefore, both groups become comparable in late/post-puberty. Early puberty may thus represent a window during which metabolic alterations are transiently apparent in girls at risk of PCOS.

Associations Between Maternal Pregravid Obesity and Gestational Diabetes and the Timing of Pubarche in Daughters.

We investigated whether in utero exposure to maternal pregravid obesity and/or gestational diabetes mellitus (GDM) was associated with early puberty in girls. We used data from a longitudinal study of 421 mother-daughter pairs enrolled in an integrated health services organization, Kaiser Permanente Northern California (2005-2012). Girls aged 6-8 years were followed annually through ages 12-14 years. Onset of puberty was assessed using study clinic-based Tanner staging. We examined associations of self-reported pregravid obesity and maternal GDM with timing of the daughter's transition to pubertal maturation stage 2 or above for development of breasts and pubic hair, using accelerated failure time regression models with interval censoring to estimate time ratios and hazard ratios and corresponding 95% confidence intervals. Maternal obesity (pregravid body mass index (BMI; weight (kg)/height (m)(2)) ≥30) was associated with a daughter's earlier transition to breast and pubic hair stage 2+ in comparison with girls whose mothers had pregravid BMI <25. These associations were attenuated and not statistically significant after adjustment for covariates. Girls whose mothers had both pregravid BMI ≥25 and GDM were at higher risk of an earlier transition to pubic hair stage 2+ than those whose mothers had neither condition (adjusted time ratio = 0.89, 95% confidence interval: 0.83, 0.96; hazard ratio = 2.97, 95% confidence interval: 1.52, 5.83). These findings suggest that exposure to maternal obesity and hyperglycemia places girls at higher risk of earlier pubarche.

Psychopathologie associée aux précocités pubertaires féminines

IntroductionPuberty is a developmental process characterized by hormonal and physical changes leading to the ability of reproduction. Precocious puberty, especially in girls, has been associated with an increased incidence of emotional and behavioral problems. Adolescence is a life stage influenced both by the biological changes of puberty and the emergence of new social challenges. In individuals facing these developmental issues at a younger age than expected, the exposure to internal and external stress factors may be greater than in other young people. MethodsThis narrative review provides an overview of psychopathology associated with precocious puberty in order to raise awareness of clinicians dealing with adolescents at risk for adverse behavioral and emotional outcomes. Developmental challenges of standard puberty and adolescence will be outlined before a more detailed description of recent findings from clinical and epidemiological studies. Putative mechanisms underlying the association between precocious puberty and psychopathology will also be discussed. ResultsEpidemiological studies have shown that an early onset of puberty in girls is associated with an earlier onset of sexuality, an earlier age of first birth and a lesser professional qualification regardless of cognitive abilities and socio-economic status. In both population studies and clinical cohorts, girls with an early age of puberty or in treatment for precocious puberty have more disruptive behavior disorders such as conduct disorders, more substance abuse disorders and delinquent behavior compared to their standard developing peers. Precocious puberty and behavioral problems may have common genetic and environmental risk factors. In young people with conduct disorders and early puberty, findings have emphasized the role of non-shared environmental factors. Low birth weight, obesity, exposure to endocrine-disrupting chemicals and adoption are potentially shared between both conditions. Early puberty in girls is also associated with psychosocial stressors and at-risk environments. The early development of secondary sexual characteristics in girls attracts older and more deviant peers, raising probability of sexual contacts but also of drug use and of a disengagement in school activities. Adolescence is the life stage during which prevalence of depressive disorders rises significantly, especially in girls. Hormonal changes and increase of the Body Mass Index leading to dissatisfaction with body image, have been put forward to explain this trend. Psychosocial challenges (emerging sexuality, instability of identity and social role) are other sources of stress at this particular period of life characterized by emotional hyper-reactivity. These stressors may have greater impact in young people showing a discrepancy between physical and affective maturation. Follow-up studies have shown that emotional and behavioral problems tend to lessen with time. Nevertheless, a heightened risk of depressive disorder remains in girls having had an early onset of puberty when other risk factors co-exist. ConclusionEarly puberty, especially in girls, has been associated with a number of emotional and behavioral symptoms and difficulties in adaptive functioning. Even though these adverse outcomes seem to lessen with time, heightened risk for depression and negative impact on socio-professional outcomes persist in subjects with other risk factors. The impact of treatment of precocious puberty on psycho-behavioral outcomes is currently unknown. However, clinicians should be aware that the social and emotional challenges these adolescents with atypical pubertal development have to face put them at risk for psychopathology and are potentially accessible to preventive actions.

Bisphenol A: Understanding the Controversy.

Healthy People 2020 lists Bisphenol A (BPA) as a potential endocrine disruptor for which exposure should be reduced. The Healthy People 2020 Environmental Health Objectives focus on addressing environmental factors that negatively affect individuals' health even though the health effects of some toxic substances are not yet fully understood. An American Association of Occupational Health Nurses (AAOHN) position statement outlined the role occupational health nurses play in creating healthy and productive workplaces by promoting worker health. BPA is implicated in a variety of health outcomes such as breast and prostate cancer, menstrual irregularities, genital abnormalities in male babies, infertility in men and women, early puberty in girls, and metabolic disorders such as diabetes and obesity. The overall health issues attributed to BPA exposure are complex and controversial. Concerns regarding environmental health are growing as individuals become more dependent on plastics. Numerous health concerns have been directly connected to daily exposures to products manufactured with BPA. Government agencies support the use of BPA as a safe consumer product with the exception of BPA use in baby bottles and sippy cups, which has been banned in the United States and several other countries. Many agencies (e.g., Federal Drug Administration [FDA], World Health Organization [WHO], U.S. Department of Health & Human Services [U.S. DHHS], and the Centers for Disease Control and Prevention [CDC]) have expressed "some concern" about BPA based on research, and stated further research is warranted.

Contemporary Trends in Onset and Completion of Puberty, Gain in Height and Adiposity.

Recent studies have documented earlier pubertal maturation in both girls and boys. Several factors have been proposed to account for earlier maturation. Epidemiologic studies have indicated that genetic factors are the most important influence contributing to the variability in the onset of puberty. Studies have also noted the association of elevated BMI with earlier puberty in girls, although the relationship between BMI and onset of puberty in boys is less consistent. The relationship of BMI and onset of puberty may be mediated by several factors, including leptin and kisspeptin, changes in bioavailable sex hormones, and environmental exposures. Recently, there have been genome-wide meta-analyses examining onset of puberty and anthropometric traits that may provide insight into the relationships of BMI, height velocity, and pubertal timing. Newer fields of investigation include examination of epigenetic modification.

Psychological assessment of mothers and their daughters at the time of diagnosis of precocious puberty.

BackgroundConcerns about psychological distress are often used to justify treatment of girls with precocious puberty, but there is little evidence to support these concerns. The extent to which psychological problems are associated with central precocious puberty (CPP) compared with other forms of early puberty in girls has likewise not been established.MethodsGirls presenting with untreated CPP, premature adrenarche (PA) or early normal puberty (ENP) were recruited from our pediatric endocrine clinic along with their mothers. Child psychological adjustment was assessed by child self-report and parent report. Parent self-reported personality, anxiety, and depression were also assessed. Differences between groups were explored using one-way ANOVA and Dunnett’s T3 test.ResultsSixty-two subjects (aged 7.5 ± 1.4 years, range 4.8-10.5) were enrolled, of whom 19 had CPP, 22 had PA, and 21 had ENP. Girls with ENP were significantly older (8.9 ± .9 years) than girls with CPP (6.9 ± 1.1 years, p < .001) and PA (6.6 ± 1.0 years, p < .001). Girls with PA had significantly higher BMI z-scores (1.7 ± .8) than girls with CPP (1.1 ± .6, p = .01) and ENP (1.2 ± .6, p = .04). More girls with PA and ENP were from racial minorities (47% and 50% respectively) than girls with CPP (32%). No group differences were found for any child measure of psychological adjustment. However, mothers of girls with PA scored significantly higher than mothers of girls with ENP on one measure of depression (p = .04) and stress (p = .01).ConclusionsWhile mothers of girls with PA report increased psychological distress on some measures, no differences in psychological adjustment were found at baseline amongst the girls themselves. Whether these results will change as puberty progresses in the PA and ENP groups or with treatment of CPP is unknown. Long-term prospective studies are needed in order to further investigate psychological correlates of early puberty in girls.

Even transient rapid infancy weight gain is associated with higher BMI in young adults and earlier menarche.

BackgroundEarly postnatal rapid “catch-up” weight gain has been consistently associated with subsequent higher obesity risk and earlier pubertal development. In many low- and middle-income countries, infancy catch-up weight gain is transient and often followed by growth faltering. We explored the hypothesis that even transient catch-up weight gain during infancy is associated with later obesity risk and earlier puberty.Methods2352 (1151 male, 1201 female) black South African children in the Birth to Twenty (Bt20) prospective birth cohort study (Johannesburg-Soweto) underwent serial measurements of body size and composition from birth to age 18 years. At age 18 years, whole-body fat mass and fat-free mass were determined using dual energy x-ray absorptiometry. Pubertal development was assessed by the research team between ages 9 and 10 years, and recorded annually from age 11 years using a validated self-assessment protocol.ResultsCatch-up weight gain from birth to age 1 year, despite being followed by growth faltering between ages 1 and 2 years, was associated greater mid-upper arm circumference (p=0.04) and skin fold thickness (p=0.048) at age 8 years, and with higher weight (p<0.001) and BMI (p=0.001) at age 18 years after adjustment for sex, age, smoking during pregnancy, birth order, gestational age, formula-milk feeding and household socio-economic status. Infancy catch-up weight gain was also associated with younger age at menarche in girls (p<0.001). This association persisted after adjustment for smoking during pregnancy, birth order, gestational age, formula-milk feeding and household socio-economic status (p=0.005).ConclusionTransient catch-up weight gain from birth to age 1 year among children born in a low-income area of South Africa was associated with earlier menarche and greater adiposity in early adulthood. This observation suggests that modifiable determinants of rapid infancy weight gain may be targeted in order to prevent later obesity and consequences of earlier puberty in girls.

Cortisol Response to Psychosocial Stress in Chinese Early Puberty Girls: Possible Role of Depressive Symptoms.

Objective. The present study aimed at investigating unique patterns of salivary cortisol reactivity and recovery in response to a social stressor among girls with early puberty and exploring possible role of depressive symptom in this association. Design. Case-control study. Patients. Fifty-six girls with early puberty and age- and body mass index- (BMI-) matched normal puberty controls (n = 56) were selected. Measurements. Salivary cortisol was measured in response to the Groningen Social Stress Test for Children. Results. Girls with early puberty had higher cortisol concentration at the end of the GSST (C3), cortisol concentration 20 min after the end of the GSST (C4), and AUC increment (AUCi) compared to non-early puberty girls. Depressive symptoms correlated with blunted HPA reactivity among girls with early puberty. Conclusion. This study demonstrated the disturbance effect of objectively examined early pubertal timing on HPA axis responses. It also suggested that stress reactivity might be blunted for individuals with depressive symptoms.