A recent study has found that girls who receive antibiotics during their first year of life are at a higher risk of developing precocious puberty. This discovery is raising concerns as cases of early puberty have surged by more than 70% over the past five years.
According to South Korea’s Health Insurance Review and Assessment Service, the number of patients diagnosed with precocious puberty rose from 108,575 in 2019 to 186,726 in 2023—an alarming trend that parents can no longer afford to ignore.
A research team led by Dr. Yoonsoo Choi of Hanyang University Medical Center presented their findings at a joint conference of the European Society for Pediatric Endocrinology (ESPE) and the European Endocrine Society (ESE), held in Copenhagen, Denmark, on May 10.
Central precocious puberty (CPP), or early puberty, is a condition where secondary sexual characteristics appear unusually early, before age 8 in girls and before age 9 in boys. Though the condition primarily affects girls, its causes remain largely unknown, despite a steady increase in incidence over the decades.
The study analyzed data from 322,731 infants in South Korea, all under 12 months old, tracking girls until age 9 and boys until age 10.
The results were striking: girls who received antibiotics before the age of three months were 33% more likely to develop early puberty. The risk rose to 40% for those prescribed antibiotics within the first two weeks of life. The findings also showed that girls exposed to five or more classes of antibiotics had a 22% higher risk than those who received two or fewer classes.
Interestingly, the study did not find a statistically significant link between early antibiotic use and precocious puberty in boys.
Dr. Choi explained, “Previous research shows that exclusive breastfeeding reduces the risk of CPP. This supports the idea that early-life factors affecting gut microbiota or endocrine-metabolic pathways can influence pubertal development.”
“Our findings may encourage doctors and parents to weigh the long-term implications of antibiotic use when making treatment decisions for infants. Understanding these biological mechanisms better could help promote safer prescribing practices and improve early intervention strategies,” he added.
The effects of precocious puberty can be far-reaching. Early exposure to sex hormones may lead to the premature closure of growth plates, resulting in a final adult height 5 to 10 cm shorter than average.
Girls may also suffer from severe menstrual cramps and irregular periods, and face a higher risk of developing breast or ovarian cancer. Early puberty has also been associated with earlier onset of menopause.
Emotional and psychological impacts are equally severe. Children going through puberty early often struggle with anxiety, depression, and social difficulties, as their physical development can cause them to feel out of place among peers. The hormonal imbalance accompanying early puberty can also disrupt the function of other organs.
While antibiotic use is an important factor, it is only one of many potential contributors to precocious puberty. Genetics plays a major role, with children whose parents experienced early puberty at higher risk.
Obesity and poor dietary habits are also key contributors. Diets high in calories and low in nutritional value, particularly those resembling Western eating patterns, can increase body fat and leptin hormone levels, which may trigger early hormone production.
Environmental hormones and endocrine disruptors such as DDE, PBB, and PCB—commonly found in plastics, pesticides, and canned foods—are also known to mimic or interfere with natural hormone activity, potentially accelerating puberty.
Psychosocial stress and lack of sleep are increasingly recognized as contributing factors. Academic pressure, family issues, and other forms of stress, along with inadequate sleep during crucial growth periods, can lead to hormonal imbalances that raise the risk of early puberty.
Certain medical conditions may also trigger early puberty, especially in boys. These include congenital brain malformations, brain tumors, hypothyroidism, and tumors of the ovaries, testicles, or adrenal glands. Boys are more likely than girls to have pathological causes of early puberty.
Other risk factors include being born significantly underweight or experiencing sudden changes in environment or routine.
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