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General Endocrinology

MON-860 - Impact of the COVID-19 Pandemic on the Incidence of Precocious Puberty: A Systematic Review

Monday, June 15, 2026
9:00 AM - 2:00 PM CT


Introduction: Central precocious puberty (CPP) results from early activation of the hypothalamic–pituitary–gonadal axis and is more frequent in girls. During the COVID-19 pandemic, lifestyle changes such as increased screen time, reduced physical activity, sleep disruption and psychosocial stress have been proposed as modulators of pubertal timing.

Objective: To evaluate changes in the incidence and clinical presentation of CPP during the COVID-19 pandemic compared to the pre-pandemic period.


Methods: Systematic review conducted according to PRISMA guidelines. Searches were performed in PubMed, LILACS and ScienceDirect using the terms “Precocious Puberty” AND “COVID-19” AND “Pandemic”. Observational studies in pediatric populations published in the last three years were included. Two independent reviewers screened studies. Of 49 records identified, 12 met inclusion criteria. Data on incidence, progression, Tanner staging and GnRH analogue use were extracted. Methodological quality was assessed using standardized tools, showing moderate risk of bias.

Results: Most studies demonstrated increased CPP incidence during or after the pandemic, with rises such as 7.3% to 14.3% (p < 0.005) and annual increases up to 10.5% (p < 0.001). Accelerated progression was observed, predominantly at Tanner stages II and III at diagnosis, along with more advanced pubertal stages and increased use of GnRH analogues. Behavioral factors, including increased screen time, reduced physical activity and sedentary lifestyle, were consistently associated. Some studies reported no significant differences, indicating heterogeneity.

Conclusion: The pandemic was associated with increased incidence and accelerated progression of CPP, particularly in girls, likely influenced by lifestyle changes. The increased use of GnRH analogues appears to reflect the need to control the more rapid pubertal progression observed in this period. Despite consistent trends, methodological heterogeneity and predominance of retrospective studies limit causal inference.

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