Endocrine Abstracts (2008) 17 P21

Premature sexual maturation: incidence and aetiology

S Stanley, E Stone & J Kirk


Birmingham Children’s Hospital, Birmingham, UK.


Over the last few years, we have seen increasing numbers of referrals to our regional paediatric endocrine unit with premature sexual maturation (PSM), especially adrenarche and isolated thelarche. Therefore, we audited referrals for PSM over three years, and compared them to published historical data collected over 15 years in another regional paediatric endocrine unit (Bridges et al. 1994).

Current dataBridges et al. (1994)
Female (no,%)Male (no,%)Female (no,%)Male (no,%)
Adrenarche59 (50.9)18 (64.3)20 (10.2)8 (50)
CPP26 (22.4)6 (21.4)88 (44.7)4 (25)
Premature thelarche18 (15.5)52 (26.4)
Thelarche variant11 (9.5)30 (15.2)
Isolated menarche2 (1.7)
GIPP2 (7.1)6 (3.0)2 (12.5)
CAH2 (7.1)2 (12.5)
CPP, central precocious puberty; GIPP, gonadotropin independent precocious puberty; CAH, congenital adrenal hyperplasia.

Results: About 144 children presented to our unit with PSM between 2005 and 2007 (mean 48 referrals/year); 116 girls (median age 7.41 years, range 0.52–12.54 years) and 28 boys (median age 8.63 years, range 3.14–12.54 years). Bridges et al. (1994) identified 213 children presenting with PSM over 15 years (mean 14.2 referrals/year).

Conclusions: Based on our data, the overall number of referrals for PSM has risen, especially adrenarche, although numbers of children with premature thelarche, thelarche variant and CPP also appear to be increased. The proportion of children with PSM diagnosed with adrenarche also appears to have risen. It is unclear whether the increased incidence of PSM reported here is due to a true increase or heightened recognition by healthcare professionals, and further work is needed to clarify this.

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