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Abstract
The COVID-19 pandemic was associated with a marked increase in central precocious puberty (CPP), especially in girls.
- Pooled estimates indicate higher odds of CPP during the pandemic compared to pre-pandemic periods.
- Evidence suggests a reproducible epidemiological signal, though no single causal mechanism has been established.
- Proposed contributing factors include sedentary behavior, weight gain, increased screen exposure, and sleep disruption.
- Psychological stress, altered healthcare-seeking behavior, and exposure to environmental endocrine-disrupting chemicals (EDCs) are also considered.
- Recent toxicology data show certain environmental compounds may activate signaling related to puberty in experimental systems.
- The relationship between pediatric exposure levels and disease causality remains unproven, framing findings as hypothesis-generating.
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