The worldwide incidence of precocious puberty, which is associated with negative
health outcomes, is increasing. Several studies have suggested that
environmental factors contribute to the development of precocious puberty
alongside genetic factors. Some epidemiological studies have provided limited
evidence suggesting an association between exposure to air pollution and changes
in pubertal development. This systematic review aimed to summarize existing
evidence on the association between air pollution exposure and precocious
puberty. Following the Preferred Reporting Items for Systematic reviews and
Meta-Analyses guidelines, we searched two databases (PubMed and Web of Science)
until August 2023. The included studies assessed the association between air
pollutant exposure and the risk of precocious puberty, early menarche, or
pubertal development. Two authors independently performed study selection and
data extraction. A meta-analysis and analysis of the risk of bias were
infeasible due to the limited number of studies and the heterogeneity among
them. The literature search resulted in 184 studies, from which we included six
studies with sample sizes ranging from 437 to 4,074 participants. The studies
reported heterogeneous outcomes. Four studies found that increased exposure to
air pollution was related to earlier pubertal onset. One study was inconclusive,
and another suggested that air pollutant exposure may delay the onset of
thelarche. Most studies suggest that exposure to air pollutants accelerates
pubertal development; however, the results from the available studies are
inconsistent. More extensive and well-designed longitudinal studies are required
for a comprehensive understanding of the association between air pollution and
precocious puberty.
Citations
Citations to this article as recorded by
Environmental factors trigger pubertal development Sofia Malave-Ortiz, Cameron Grant, Natalie D. Shaw Current Opinion in Pediatrics.2025;[Epub] CrossRef
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