Precocious puberty

There are no recommended screening programs to detect children with abnormal pubertal development. However, since most patients with precocious puberty have tall stature and, in particular, a rapidly advancing growth velocity, these findings should warrant review by the family practitioner. Accurate measurements, using correct age- and sex-specific growth charts, are mandatory. Care must be taken to plot the height and weight based on the child's actual chronological age.

Growth is strongly related to the genetic potential. The target or midparental height is calculated as follows:

• Girl = ([height of mother in cm + height of father in cm]/2) - 7 cm.

• Boy = ([height of mother in cm + height of father in cm]/2) + 7 cm.

Growth velocity determines the change in height over time. It is calculated as the difference in height on two different occasions annualised over a year. Height that plots stably along a given percentile on the growth chart reflects normal growth velocity. Crossing percentiles in an upward direction reflects an accelerated growth velocity.

Better public awareness of normal puberty in terms of the age of onset of specific changes may result in families presenting more appropriately and at an early stage of development.