The tempo of puberty and its relationship to adolescent health and well‐being: A systematic review

Abstract

Puberty is a major developmental period characterised by the height growth spurt, appearance of secondary sex characteristics, body composition alterations and increasing circulating hormone levels. 1,2 Variability exists in how early (timing of onset) and rapidly (tempo of puberty) individuals commence and progress through these changes.Such variability is known to have immediate and lifelong impacts on health and well-being which, in turn, has clear implications to practice in terms of identifying and delivering timely supportive therapies to those exhibiting "at risk" developmental trajectories.The clinical and hormonal markers of pubertal onset, together with the age range at which onset occurs, are well recognised. The first signs of puberty are measured by the attainment of Tanner stage (TS) 2 for breast (B2) or genital (G2) development, or a rise in gonadal hormones above the childhood range. 3 The typical age of onset ranges from 8 to Cheng and Harris contributed equally to this work.Abbreviations: ATO, age at height take-off; APHV, age at peak height velocity; B2/5, Tanner breast development stage 2/5; BMI, body mass index; G2/5, Tanner genital development stage 2/5; TS Tanner stage; zBMI, age-and sex-adjusted body mass index z-score Abstract Aim: Emerging evidence suggests that pubertal tempo, that is rate of passage through puberty, has relevance to adolescent mood and behaviour. However, its wider health and developmental significance remain unclear. This systematic review sought to clarify the relationship of pubertal tempo to indicators of health and development, and to document tempo definitions and pubertal durations reported in the literature. Methods: Eight electronic databases were searched from earliest record to July 2018. Study eligibility: healthy participants; age 8-21 years; ≥2 longitudinal measures of puberty; analysis of tempo against a health or developmental indicator. Results: Thirty-eight studies met eligibility, and these reported on diverse tempo definitions and seven health-and development-related domains. Data sets with varying tempo definitions converged on an association of rapid pubertal progression to: (a) higher adiposity during childhood and adolescence in both sexes; and (b) lower psychosocial well-being in adolescent males. Later thelarche unanimously predicted faster progression to menarche in females, but this compensation was largely undetected when alternate definitions of pubertal timing and/or tempo were used. Duration of puberty ranged from 2.5-4.1 years. Conclusion: Pubertal tempo may be clinically relevant when considering trajectories of adiposity and psychosocial well-being among adolescents, especially males. Consensus on the definition of tempo would facilitate between-study comparisons. K E Y W O R D S adiposity, adolescence, behaviour problems, depression, pubertal pattern | 901 CHENG Et al. S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. How to cite this article: Cheng HL, Ha...

Progression of Gender Dysphoria in Children and Adolescents: A Longitudinal Study

“…Although some reports indicate that transgender boys and transgender girls experience differences in parental acceptance, 59 a more likely reason is that endogenous puberty occurs later in natal boys, and, because gender dysphoria typically worsens with pubertal progression, children who were AMAB might seek and receive gender-affirming care later than their AFAB counterparts. 60 Moreover, current Endocrine Society and WPATH guidelines recommend GAHT initiation once Tanner 2 stage is reached; this occurs on average later in AMAB children compared with their AFAB peers. 11 , 12 One could also argue that the observed disparity in GAHT initiation between AMAB and AFAB participants is attributable to the differences in the cost of therapy.…”

Biological Maturity Status in Elite Youth Soccer Players: A Comparison of Pragmatic Diagnostics With Magnetic Resonance Imaging

“…However, there is disagreement in the literature with regard to the inconsistency of definitions (Cheng et al, 2020) and which indicators are assigned to which approaches (BMS vs. maturity timing vs. maturity tempo). For example, several authors use APHV (Buchheit and Mendez-Villanueva, 2014;Deprez et al, 2015) as an indicator of BMS, despite the fact that the review by Swain et al (2018) argues that APHV reflects an indicator of maturity timing.…”

Highlights in this issue

“…Parental and household factors were not significantly associated with the timing of puberty. Readers may also be interested in a review on the timing of puberty, and its relationship to adolescent health and well‐being, by Cheng et al 4 …”