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ARTICLES: Grete Teilmann, Carsten B. Pedersen, Niels E. Skakkebæk, and Tina Kold Jensen Increased Risk of Precocious Puberty in Internationally Adopted Children in Denmark Pediatrics 2006; 118: e391-e399 [Abstract] [Full text] [PDF]

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Precocious puberty or under-recorded age?

Peter Hayes   (19 May 2007)

Precocious puberty or under-recorded age? 19 May 2007
Peter Hayes, Senior Lecturer in Politics University of Sunderland Send letter to journal: Re: Precocious puberty or under-recorded age? peter.hayes{at}sunderland.ac.uk Peter Hayes	The authors find that there is a greatly increased chance of internationally adopted children in Denmark entering into precocious puberty. The obvious explanation is that the children concerned are older than the age on their birth certificate. The authors reject this possibility after making what they call the worst-case assumption that children aged over two at the time of adoption are one year older than their official age and finding there is still an increased risk. The authors do not, however, explain why they think that a one year age gap is a maximum; there are higher probable age gaps recorded (eg, A. Carli, Latin American children adopted in Norway, in P. Selman, ed Intercountry Adoption, London, BAAF, 2000) and the true maximum is more likely to be two or even three years. When the age of a child is unknown, adoption agencies are often responsible for assigning an age themselves. Given that most adoptive parents have a prior preference for young children, there is a temptation to systematically underestimate dates of birth. The authorsEfinding that the older the child is at the age of adoption the more likely they are to experience precocious puberty exactly corroborates the suggestion that this apparent precocity is actually due to the under-recording of the age of the child. The older the child at the age of adoption, the greater the plausible gap between their true age and their assigned age. Babies are obviously babies, but how old is a child who is said to be four? The finding that there is no evidence of an increased risk of precocious puberty amongst children adopted from Korea provides further corroboration, as 99% of these children were aged under two at adoption. If this explanation of precocious puberty is correct, the implications of the article lie not with exploring the early life experiences of the children concerned, but rather with how best to counsel them. A child can be reassured that they are probably not exceptionally early in reaching puberty after all. However, the child is then faced with coming to terms with the educational and legal disjuncture between their official age and their probable true age. Conflict of Interest: None declared