Prevalence and associated family and lifestyle factors of precocious puberty in children

Precocious puberty is an endocrine-related developmental disorder characterized by the premature onset of secondary sexual characteristics. Early pubertal development may adversely affect physical growth, psychosocial well-being, and long-term health. This study investigated the hospital-based proportion of children diagnosed with precocious puberty and explored associated family and lifestyle factors. We conducted a single-center retrospective observational study with an age- and sex-matched case-control analytic component, using clinical and questionnaire data collected from pediatric patients treated at our hospital between January 2021 and January 2023. Among 6021 screened children, 53 diagnosed with precocious puberty were included as cases, and 53 age- and sex-matched children with normal growth and development served as controls. Demographic characteristics, family background, and lifestyle habits were compared between groups. Exploratory correlation analysis was used to assess associations between selected family/lifestyle variables and precocious puberty status. The proportion of children diagnosed with precocious puberty among the 6021 surveyed pediatric patients was 0.88% (53/6021). No significant between-group differences were found in baseline demographic variables. However, children with precocious puberty more often had parents with unstable marital status, mothers with lower educational attainment, maternal employment outside the home, and shorter parental companionship time. In addition, late bedtime, reduced weekly exercise, and preference for emotionally oriented screen-based entertainment were more common in the precocious puberty group. Exploratory correlation analysis was consistent with associations between these family and lifestyle factors and precocious puberty status. In this single-center hospital-based cohort, 0.88% of surveyed pediatric patients were diagnosed with precocious puberty. Precocious puberty status was associated with several family- and lifestyle-related characteristics, including parental marital status, maternal education and occupation, parental companionship time, bedtime, physical activity, and hobby patterns. Because this observational study did not include multivariable adjustment, these findings should be interpreted as associations rather than independent or causal effects. Prospective studies with multivariable analyses are needed to determine whether these factors have independent or modifiable relationships with pubertal timing.