Precocious puberty in adoptees. What are the risk factors?

What is precocious puberty?

Precocious puberty is the appearance of sexual characteristics before the age of 8 years in girls and before the age of 9 years in boys. The risk of developing precocious puberty is 20 to 30 times higher in children adopted from abroad than in the general child population.

The onset of puberty and its progression depends on neurohormonal factors, that is, on the activation of the hypothalamic-pituitary-gonadal axis. Nutritional and psycho-affective factors are also involved in the development of precocious puberty.

The consequences of precocious puberty are, in addition to the early appearance of sexual characteristics, an acceleration of growth and bone maturation. This leads to an early closure of the growth plates causing the final adult height to be smaller than it should be. This is often associated with behavioral and psychological changes and integration problems.

Risk factors for precocious puberty

The risk factors for precocious puberty in adoptees are:

  • Sex: affects girls in 90% of cases.
  • Country of origin: it is more frequently observed in those from Latin America, Southeast Asia and India.
  • Age at adoption: the incidence doubles in adoptees over 2 years of age and quadruples in adoptees over 5 years of age.
  • Nutritional status and physical development: it is more frequent in those who arrive with chronic malnutrition or with postnatal delay and who in a short period of time undergo catch-up growth, reaching their genetically determined body mass.
  • Affective deprivation and maltreatment: it is more frequent in those who present this antecedent and who quickly reach a psychic and functional stability with the new family.
See also  Growth monitoring in children

Treatment of precocious puberty

Precocious puberty has an important impact on both the physical and psychological development of the child and his family. In pediatrics, an early and accurate diagnosis determines the success of the treatment and the favorable evolution of the clinical picture. For this reason, it is recommended that children adopted from abroad be monitored periodically for growth in height, weight, bone maturation and the appearance of sexual characteristics.