Risk factors and preventive strategies for precocious puberty: a narrative review

Precocious puberty (PP) is a common pediatric endocrine disorder with rising global incidence, significantly compromising children's quality of life and long-term health. Current therapeutic options remain limited in applicability, leaving many patients inadequately controlled. Prevention targeting known risk factors is substantially more cost-effective than post-diagnosis treatment; however, the available evidence on PP risk factors remains fragmented. This review systematically synthesizes the risk factors for PP across seven age stages—preconception period, fetal period, infancy, toddlerhood, preschool age, school age, and adolescence—and eight domains: genetic predisposition and family history, maternal conditions and prenatal factors, delivery mode and early feeding patterns, dietary behaviors and nutritional status, individual lifestyle habits, family/school/community environments, early clinical signs and indicators, and pre-existing and idiopathic medical conditions. Corresponding preventive strategies, including optimizing parental reproductive health, promoting balanced nutrition, physical activity, and psychosocial well-being, and fostering multi-sector collaboration, are briefly discussed. This review aims to raise awareness of PP risk factors and facilitate the implementation of preventive strategies.