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Thelarche, Pubarche, And Menarche Attainment In Children With Normal And Elevated Body Mass Index

June 07, 2017

UroToday - A study by Dr. Robert Rosenfield et al. evaluated the effect of body mass index on puberty. Data was collected from the NHANES III database. From their study, the group has been able to provide normative estimates for the ages of which thelarche, pubarche, and menarche will occur in U.S. children with normal BMI.

The group found that if a child is of normal weight, breast and sexual pubic hair development are unusual before 8 years of age in girls and pubarche is unusual before 10 years of age in boys occurring less than 2% of the time. They did find that higher BMI's and ethnicity are independently associated with earlier pubertal development in girls. The group states that BMI should be a major consideration in evaluation of pubertal development that occurs before 8 years of age. This is true only in breast development. One has to assess whether the breast development is due to adipose deposition or is it a truly and onset of puberty. Nonetheless they state that breast development in girls with a normal BMI occurring before the age of 8 is considered premature and any pubic hair development before 8 years of age in girls and 10 girls in boys is considered premature in those with a normal BMI across all ethnic groups.

In my opinion since obesity is on the rise in the United States, we have to be cognizant of the profound impact it can have on childhood health. It seems that earlier onset of puberty is another variable we have to be aware of in keeping these children healthy.

Rosenfield RL, Lipton RB, Drum ML
Pediatrics. 2009 Jan;123(1):84-8.
doi:10.1542/peds.2008-0146

UroToday Medical Editor Pasquale Casale, MD

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