Global prevalence and incidence of precocious puberty: a systematic review and meta-analysis.

BACKGROUND: The significant rise in precocious puberty rates over recent decades has adversely impacted children's health, spurring numerous epidemiological studies. However, prevalence and incidence estimates vary widely across regions and lack a comprehensive global perspective. Therefore, we estimated the global prevalence and incidence of precocious puberty among children. METHODS: We comprehensively searched PubMed, Embase, and Web of Science from inception to February 2024 for articles reporting the prevalence or incidence of precocious puberty. For studies based on cross-sectional surveys, we used a random-effects model to estimate the pooled prevalence and 95% confidence interval (CI) of precocious puberty in girls and boys. The 95% CI was calculated using the inverse-variance method, which accounts for both within-study and between-study variability. Subgroup analyses considered socioeconomic and individual characteristics. For studies based on medical registration data, we described the results individually due to significant heterogeneity, rather than pooling the data. RESULTS: Of 8737 articles identified, 27 were included. Survey-based studies showed pooled prevalence estimates of 7.87% (95% CI: 5.90%-9.84%) for girls and 3.98% (95% CI: 2.70%-5.25%) for boys. European and the United States studies were generally conducted earlier than those in Asia. Older and obese children exhibited significantly higher prevalence. Registry-based studies reported overall prevalence ranging from 37 to 935.1 per 100,000 girls and from 0.46 to 37.4 per 100,000 boys, with incidence ranging from 1.123 to 489.3 per 100,000 girls and from 0.096 to 22.4 per 100,000 boys. CONCLUSIONS: This study synthesized the global prevalence and incidence of precocious puberty, offering valuable insights for public health awareness and policy-making. Further research is needed to enhance understanding of the condition and to guide targeted interventions. TRIAL REGISTRATION: PROSPERO number: CRD42024508384.