IMPE Abstracts

Introduction: Several studies suggested that there was an increased incidence of precocious puberty in girls during the lockdown for COVID-19 pandemic.

Objective: To compare clinical and biochemical parameters in ICPP girls treated before and after lockdown.

Patients and methods: Electronic registry data from girls treated with GnRH analogue (GnRHa) attending at a single Hospital, belonging to the same health coverage system during a period of 140 months were retrospectively assessed. Clinical data (age at beginning of treatment, bone age, height, weight, age of maternal menarche) and complementary studies (ovarian volume, uterine length and hormonal dosages) at beginning of treatment were analyzed. They were divided into group 1; covid lockdown (between March 2020 and June 2021, n=30) and group 2; pre-pandemia (between January 2010 and February 2020; n=45).

Results: During lockdown period, there was an increase in the number of patients who started treatment (1.87 patients/month vs 0.36 patients/month, P<0.05). Age at beginning GNRHa (8.5 vs 8.2 years), baseline bone age (9.9 vs 9.6 years), height Z-score (1.45 vs 1.43 SDS), maternal menarche age (12.2 vs 11.7 years), dominant ovarian volume (4.2 vs 3.1 cc) and uterine length (37.1 vs 36.4 mm) were not significantly different. However, weight for height (99.4 vs 105.7 %, p 0.03), basal levels of LH (2.6 vs 1.3 mU/L, p 0.05), FSH (4.5 vs 3.2 mU/L, p 0.01) and Estradiol (27.5 vs 16.2 pg/ml, p 0.03) were significantly different. MRI was performed in 2/30 (6%) girls in group 1 and 15/45 (33%) in group 2; and LHRH test, in 2/30 (6%) in group 1 vs 28/45 (62%) in group 2.

Conclusions: During the lockdown period, the number of ICPP girls treated with GnRHa increased significantly. This was not related to changes in weight. Starting treatment in more advanced puberty stages may explain biochemical differences. High complexity complementary studies (MRI, LHRH test) were less useful for making decisions.