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Abstract
In 1997 a study from the Pediatric Research in Office Settings network, based on pubertal staging of >17 000 girls between 3 and 12 years of age, indicated that breast and pubic hair development are occurring significantly earlier than suggested by our current guidelines, especially in African-American girls. In response to this article, the Lawson Wilkins Pediatric Endocrine Society undertook a comprehensive review of this topic. The primary conclusions of this review are:
1. The current recommendation that breast development before age 8 is precocious is based on outdated studies. Until 1997, no data were available on pubertal staging in US girls that could have documented a trend to earlier maturation.
2. The 1997 study indicates that stage 2 of breast and pubic hair development is being achieved ∼1 year earlier in white girls and 2 years earlier in African-American girls than previous studies have shown.
3. Concerns that girls with moderately precocious puberty will be significantly short adults are overstated; most have adult height within the normal range.
4. Therapy with gonadotropin-releasing hormone agonists has not been proven to have a substantial effect on adult height in most girls whose puberty starts between 6 and 8 years of age.
5. New guidelines propose that girls with either breast development or pubic hair should be evaluated if this occurs before age 7 in white girls and before age 6 in African-American girls. No changes in the current guidelines for evaluating boys (signs of puberty at younger than 9 years) can be made at this time. normal puberty, breast development, pubic hair.
- Received February 8, 1999.
- Accepted March 29, 1999.
- Copyright © 1999 American Academy of Pediatrics
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