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The Timing of Normal Puberty and the Age Limits of Sexual Precocity: Variations around the World, Secular Trends, and Changes after Migration

Division of Ambulatory Pediatrics and Adolescent Medicine (A.-S.P., J.-P.B.), University of Liège, B-4000 Liège, Belgium; Department of Growth and Reproduction (G.T., A.J., N.E.S.), Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen Ø, Denmark; and Departments of Paediatrics and Physiology (J.T.), University of Turku, 20520 Turku, Finland

Correspondence: Address all correspondence and requests for reprints to: Jean-Pierre Bourguignon, M.D., Ph.D., Division of Ambulatory Pediatrics and Adolescent Medicine, University of Liège, Centre Hospitalier Universitaire Sart Tilman, B-4000 Liège, Belgium. E-mail: jpbourguignon{at}ulg.ac.be

During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western European countries. These observations are raising the issues of current differences and secular trends in timing of puberty in relation to ethnic, geographical, and socioeconomic background. None of these factors provide an unequivocal explanation for the earlier onset of puberty seen in the United States. In the formerly deprived migrating children, refeeding and catch-up growth may prime maturation. However, precocious puberty is seen also in some nondeprived migrating children. Attention has been paid to the changing milieu after migration, and recently, the possible role of endocrine- disrupting chemicals from the environment has been considered. These observations urge further study of the onset of puberty as a possible sensitive and early marker of the interactions between environmental conditions and genetic susceptibility that can influence physiological and pathological processes.

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