The Reason of Increasing Puberty Precocious Cases During the Pandemic Period: Obesity or Not?

Objective: Publications have shown increased rate of precocious puberty and rapidly progressing puberty during the pandemic period. During the pandemic period, obesity has become widespread in children due to sedentary life, an increase in the time spent at home, and prolonged use of mobile devices. Obesity is a significant contributor to early puberty in females.We aimed to investigate whether obesity is a factor in the increase of puberty precocious cases during the pandemic. Material and Methods: In the study, female patients diagnosed with Puberty precocious /Rapidly Progressive Puberty in our clinic were divided into three groups August 2019-February 2020 before the pandemic (Group1-G1), August 2020-February 2021 during the pandemic (online education - Group2-G2), August 2021-February 2022 during the pandemic (face-to-face education -Group3-G3). The groups were retrospectively compared in terms of clinical, laboratory, and imaging findings. Results: A total of 495 female patients were included in the study. There was no difference between the groups in terms of age at the presentation. The most common complaint at presentation in the three groups was thelarche. Also, presentation with combination of thelarche and pubarche was more common in G3, and presentation due to menarche was more common in G2 (p=0.011). No difference was found between the groups regarding body weight SDS, and height SDS. The BMI SDS was 0.69±1 SD for all patients, 0.78±0.94 SD for G1, 0.67±1 SD for G2, and 0.67±1 for G3, and the BMI SDS of the groups were comparable (p=0.630). The majority of patients at the presentation were Breast Tanner stage 3. G2 (9%) and G3 (9%) were presented with Breast Tanner stage 4 at a higher frequency compared to G1 (2%). There was no difference between the groups’ FSH, LH, estradiol, LHRH test peak FSH, peak LH, and LH/FSH values. There was no difference between the bone ages of the groups at the presentation. The uterus size, right and left ovary volumes of G2 and G3 were significantly bigger than those of G1 (p=0.001). No difference was found between the groups in the rates of precocious puberty and rapidly progressing puberty cases. Conclusion: In our study, the age at presentation and BMI were similar pre-pandemic group G1 and during the pandemic, online education (G2) and pandemic face-to-face education (G3). We determined that obesity may not be one of the factors triggering precocious puberty cases during the pandemic period.