Abstract
Study Objective
The aim of this study was to measure the prevalence of premature thelarche in infant
and toddler girls and to determine if environmental sources of estrogen were associated
with early breast development.
Design
Observational with mixed methods: Retrospective chart review, cross-sectional component
involving an interview survey, along with longitudinal follow-up of girls with thelarche
up to six months.
Setting
A general pediatric clinic within a teaching hospital located in a large Midwestern
city.
Participants
Girls, between the ages of 12 and 48 months, and their mothers, presenting for well-child
care.
Interventions
None.
Main Outcome Measures
Prevalence of premature thelarche; association of premature thelarche with selected
environmental exposures.
Results
Among the 318 subjects, the overall prevalence of premature thelarche was measured
at 4.7% (n = 15). The prevalence by race/ethnicity was 4.2% among White Non-Hispanics,
4.6% among Blacks and 6.5% among White Hispanics. The peak prevalence occurred between
12–17 months of age. All thelarche cases were Tanner stage 2. No statistically significant
relationship was found between premature thelarche and environmental exposures. Upon
follow-up, 44% of the cases of premature thelarche had persistent breast development.
Conclusions
Our study demonstrated a higher prevalence of premature thelarche than has been previously
reported. This study lacked power because of the small number of premature thelarche
cases, the ubiquitous presence of environmental exposure as well as the potentially
small effect of each environmental factor. Future studies need to employ a very large
sample in order to accurately analyze the relationship between environmental toxicants
and premature thelarche.
Key Words
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© 2011 Published by Elsevier Inc.
