Clinical Characteristics of Children With Precocious Puberty at Al Ahsa: A Retrospective Study

Background: Precocious puberty is a pediatric endocrine disorder characterized by the premature onset and progression of pubertal development.It may lead to accelerated growth, advanced bone age, early epiphyseal fusion, psychosocial concerns, and reduced adult height potential.Local data from Saudi Arabia remain limited.Objective: This study aimed to describe the recorded clinical characteristics, diagnostic evaluation, and management patterns of children with precocious puberty evaluated at a pediatric endocrinology clinic in Al Ahsa, Saudi Arabia.Methods: This retrospective observational study was conducted at Maternity and Children Hospital, Al Ahsa, Saudi Arabia, between 2022 and 2025.Children referred to or followed up for suspected or confirmed precocious puberty were included.Data collected included age at onset, age at diagnosis, sex, BMI category, family history, parental consanguinity, type of precocious puberty, clinical features, bone age status, brain MRI findings, and management approach.Data were summarized using descriptive statistics.Results: A total of 87 children were included.The mean age at diagnosis was 7.4 ± 2.1 years, and the mean age at onset was 6.2 ± 1.9 years.Females accounted for 74 patients (85.1%).Central precocious puberty was the predominant type, identified in 82 patients (94.3%), while peripheral precocious puberty was documented in five patients (5.7%).Overall, 49 patients (56.3%) were overweight or obese.The most common clinical findings were breast development in 74 patients (85.1%), pubic hair development in 61 patients (70.1%), and accelerated growth velocity in 56 patients (64.4%).Advanced bone age was documented in 36 patients (41.4%).Brain MRI was abnormal in seven patients (8.0%), with no hypothalamic-pituitary or suprasellar mass lesion identified.GnRH analogue therapy was prescribed in 83 patients (95.4%).Conclusion: Precocious puberty in this cohort was predominantly central and more common among girls.Overweight and obesity were frequent, and most imaged patients had normal brain MRI findings.These findings provide local data and support the need for standardized evaluation and multicenter studies in Saudi Arabia.