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Preterm birth and the timing of puberty: A systematic review

An estimated 11% of births occur preterm, and survival is improving. Early studies suggested an association between preterm birth and earlier puberty. Given the adverse outcomes associated with early puberty this could have significant public health implications. | James et al. BMC Pediatrics 2018 18 3 DOI 10.1186 S12887-017-0976-8 RESEARCH ARTICLE Open Access Preterm birth and the timing of puberty a systematic review Evlyn James1 Claire L. Wood2 Harish Nair3 and Thomas C. Williams4 Abstract Background An estimated 11 of births occur preterm and survival is improving. Early studies suggested an association between preterm birth and earlier puberty. Given the adverse outcomes associated with early puberty this could have significant public health implications. The objective of this review was to assess the timing of puberty after preterm birth. Methods Pubmed Embase Popline Global Health and Global Health Library were searched using terms relating to premature birth menarche puberty and follow up studies . Inclusion criteria were a population consisting of pubertal or post-pubertal adolescents and adults studies which defined preterm delivery in participants and compared outcomes to those after term delivery and a quantitative assessment of pubertal onset. Assessment of risk of bias was conducted using principles from the Critical Appraisal Study Process. Results Our search identified 1051 studies of which 16 met the inclusion criteria. In females 8 studies found no association between preterm birth and the timing of menarche. Five studies found earlier onset in preterm infants 1 found later onset and 1 showed both earlier and later menarche depending on birth weight. The range of effect of studies showing earlier menarche was - 0.94 to -0.07 years in the preterm group with a median of - 0.3 years. In males 2 studies showed earlier onset of puberty in the preterm group 5 showed no difference and 1 showed later onset. Most studies did not present outcomes in the form of a mean with standard deviation precluding a metaanalysis. There was insufficient data to address potential confounding factors. Conclusions The published evidence does not suggest that being born preterm leads to a significant acceleration in the onset of .