{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T17:22:16Z","timestamp":1791134536466,"version":"4.1.0"},"reference-count":27,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,10,1]]},"abstract":"<jats:p>In 1997 a study from the Pediatric Research in Office Settings network, based on pubertal staging of &amp;gt;17\u2009000 girls between 3 and 12 years of age, indicated that breast and pubic hair development are occurring significantly earlier than suggested by our current guidelines, especially in African-American girls. In response to this article, the Lawson Wilkins Pediatric Endocrine Society undertook a comprehensive review of this topic. The primary conclusions of this review are:1.\u2002 The current recommendation that breast development before age 8 is precocious is based on outdated studies. Until 1997, no data were available on pubertal staging in US girls that could have documented a trend to earlier maturation.2.\u2002 The 1997 study indicates that stage 2 of breast and pubic hair development is being achieved \u223c1 year earlier in white girls and 2 years earlier in African-American girls than previous studies have shown.3.\u2002 Concerns that girls with moderately precocious puberty will be significantly short adults are overstated; most have adult height within the normal range.4.\u2002 Therapy with gonadotropin-releasing hormone agonists has not been proven to have a substantial effect on adult height in most girls whose puberty starts between 6 and 8 years of age.5.\u2002 New guidelines propose that girls with either breast development or pubic hair should be evaluated if this occurs before age 7 in white girls and before age 6 in African-American girls. No changes in the current guidelines for evaluating boys (signs of puberty at younger than 9 years) can be made at this time. normal puberty, breast development, pubic hair.<\/jats:p>","DOI":"10.1542\/peds.104.4.936","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:45:45Z","timestamp":1092440745000},"page":"936-941","source":"Crossref","is-referenced-by-count":380,"title":["Reexamination of the Age Limit for Defining When Puberty Is Precocious in Girls in the United States: Implications for Evaluation and Treatment"],"prefix":"10.1542","volume":"104","author":[{"given":"Paul B.","family":"Kaplowitz","sequence":"first","affiliation":[{"name":"From the Department of Pediatrics, the Medical College of Virginia of Virginia Commonwealth University, Richmond, Virginia; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon E.","family":"Oberfield","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, 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