Autism and risk of precocious puberty: A cohort study of 22,208 children

Background: Autism is a common neurodevelopmental disorder in children. Evidence suggests that autism is associated with changes in puberty onset. Precocious puberty (PP) is the early development of secondary sex characteristics. This nationwide cohort study explored PP risk in autistic children. Methods: Using data from the Taiwan National Health Insurance Research Database, 11,104 autistic children and 11,104 age- and sex-matched non-autistic children were enrolled between 2001 and 2011. Participants were followed from enrollment until the end of 2011 to determine the incidence of PP. Cox regression models were used to account for confounding factors, such as demographic characteristics and physical and psychological comorbidities. Results: Autistic children were more likely than non-autistic children to experience PP (hazard ratio: 6.48, 95% confidence interval: 3.61–11.62). Subgroup analyses by sex and intellectual disability further demonstrated consistent findings that PP was more prevalent in autistic children than in non-autistic children. Conclusion: Autism is an independent risk factor for subsequent PP. Autistic children may have an increased PP risk, and early detection and treatment may reduce the psychological and physical consequences.