Background: Puberty marks a critical stage of physical and psychological development, but precocious puberty poses significant health and psychosocial risks worldwide. This review examines factors influencing precocious puberty in Iranian children compared to those in global populations.
Materials and Methods: This narrative review conducted searches up to April 2025 across databases including PubMed, Scopus, Web of Science, ScienceDirect, SID, CIVILICA, and Google Scholar. Both English and Persian keywords such as “Precocious puberty,” “Central precocious puberty,” “Genetic factors,” “Environmental factors,” “Nutritional factors,” “Socioeconomic factors,” and “Risk factors” were used. Data extraction was independently performed by two reviewers.
Results: This review highlights that precocious puberty in Iranian children arises from a complex interplay of genetic, environmental, nutritional, and socio-economic factors, reflecting global trends alongside distinct regional influences. Key genetic mutations in KISS1, KISS1R, and MKRN3, together with epigenetic modifications, significantly affect puberty onset. Environmental factors include elevated BMI, reduced physical activity, exposure to pollution, and secondhand smoke. Nutritional influences such as high animal protein intake and low dietary fiber are associated with earlier puberty, while breastfeeding provides a protective effect. Socioeconomic and cultural conditions uniquely influence the timing, diagnosis, and management of precocious puberty in Iran. Although many cases are idiopathic and benign, the condition poses risks including reduced adult height, increased susceptibility to chronic diseases, and psychological and social challenges, emphasizing the need for tailored prevention and intervention strategies.
Conclusion: Precocious puberty in Iranian children stems from genetic, environmental, nutritional, and socio-economic factors reflecting global trends. Key genetic mutations, higher BMI, pollution exposure, and diet accelerate puberty, while breastfeeding protects. Regional and cultural differences affect the condition’s prevalence, timing, and management in Iran.