Abstract

Background: Central precocious puberty (CPP) results from premature activation of the hypothalamic–pituitary–gonadal axis, with breast development before the age of 8 years being the most common clinical manifestation in girls. This study aimed to evaluate the predictive value of selected clinical features, sex hormone levels, and imaging parameters for CPP in girls.

Methods: A cross-sectional study was conducted in girls younger than 8 years presenting with early breast development at the Department of General Pediatrics, Hue University of Medicine and Pharmacy Hospital, from January to December 2025

Results: There were no significant differences between the CPP and premature thelarche (PT) groups regarding age at pubertal onset, height-for-age, or weight-for-age (p>0.05). However, significant differences were observed in breast development stage and bone age (p<0.05). Basal and GnRH-stimulated gonadotropin levels, as well as uterine and ovarian ultrasound parameters, were significantly higher in the CPP group (p<0.05). Basal luteinizing hormone (LH), LH/FSH ratio, uterine height, uterine volume, and ovarian volume demonstrated good diagnostic performance in differentiating CPP from PT (AUC >0.7; p<0.001). Among these, basal LH level, uterine volume, and ovarian volume were identified as independent predictive factors. The multivariable model combining these parameters showed high predictive accuracy for CPP, with an AUC of 0.912 (95% CI: 0.861–0.963; p<0.001).

Conclusions: A multivariable model combining basal LH, LH/FSH ratio, and uterine and ovarian ultrasound parameters provides high predictive value for central precocious puberty in girls.