A steady rise in the number of referrals for precocious puberty — development of physical signs of maturity before eight years of age in girls and nine years of age in boys — was observed during the Covid lockdown at Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital in Pune.
A team comprising Dr Vaman Khadilkar, senior paediatric endocrinologist and Dr Anuradha Khadilkar, deputy director and consultant paediatrician, among others, at the Growth and Pediatric Endocrinology Unit, conducted a study to assess the possible associations of Covid lockdown with idiopathic central precocious puberty.
In the study published in the June issue of ‘Journal of Paediatric Endocrinology and Metabolism’, the researchers said they studied early onset of puberty in children who were divided into two groups — those seen for the first time before lockdown versus during lockdown.
During lockdown, 155 (5.1 per cent; 146 girls) of 3,053 referrals for precocity as opposed to 59 (1.4 per cent; 54 girls) of 4,208 before the lockdown were reported, suggesting a 3.6 times increase in precocious puberty during lockdown.
Children referred to during the lockdown had more advanced skeletal maturity (bone age) and a larger proportion were in late stages of puberty with some even having early menstruation, suggesting that puberty not only began earlier, but also progressed faster in these children.
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It was earlier thought that binge eating and reduced physical activity during lockdown caused excessive weight gain, which is known to stimulate onset of puberty as early as less than eight years of age as well as faster progression. But this study observed that despite the lockdown, the weight of children in both groups was similar, pointing to other possible reasons for early puberty in these children, similar to results observed in Italy and Turkey, Dr Khadilkar said.
Increased use of mobile phones, late sleeping hours, stress, anxiety and depression, all are known to cause precocious puberty and these factors were prevailing during lockdown.
A substance found in sanitisers and some soaps, triclosan, which is recognised as an endocrine disrupting chemical (EDC), could also have stimulated early puberty in children, the researchers said. However, more studies are required to confirm this association, Khadilkar pointed out. EDCs are those substances present in household items or the environment that are known to alter the timing and progression of puberty.