CLINICAL CHARACTERISTICS OF PATIENTS WITH PRECOCIOUS PUBERTY ATTENDING ENDOCRINE UNITS IN MOSUL CITY

Abstract

Background: Precocious puberty is the abnormal early onset of puberty, defined by the appearance of secondary sexual characteristics before age 8 in girls and before age 9 in boys. It results from either independent sex hormone secretion (peripheral/gonadotropin-independent) or premature activation of the hypothalamic-pituitary-gonadal axis (central/gonadotropin-dependent). Aim: To determine the characteristic features and associated factors of children presenting with precocious puberty at endocrine centers in Mosul City. Methods: A cross-sectional study was conducted among 94 patients attending the Endocrine Units at Al-Khansa’a Teaching Hospital and Al-Wafa’a Specialized Medical Center between 2 January and 30 June 2025, using a structured questionnaire administered through direct interviews. Results: The sample comprised 94 children (78 females. [83%], 16 males. [17%]) aged 1–10 years, with the majority (47.9%) aged 7–8 years; females predominated in younger age groups and males in older groups. Younger girls showed below-average height but elevated weight and BMI Z-scores (Z = +5.6 at age 3), normalizing by age 8, whereas boys showed above-average height and weight in mid-childhood but below-standard values in older ages. Urban residence was common (58.5%), and family history was positive in only 9.6% of cases (all females). Central precocious puberty predominated (74.5%), mostly idiopathic (71.3%); peripheral precocious puberty accounted for 25.5%, primarily congenital adrenal hyperplasia (21.3%). Breast budding was the first sign in 88.5% of females and scrotal enlargement in 62.5% of males. Treatment adherence was high in females (87.2%) but low in males (12.5%). Conclusion: Idiopathic central precocious puberty predominates among Mosul’s pediatric population, with marked gender disparities in presentation, anthropometric deviations, and treatment adherence, underscoring the need for targeted screening, early intervention, and gender-specific strategies in resource-limited settings.