Postnatal Bisphenol A exposure and risk of precocious puberty in children: updated systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review of non-randomized observational studies
PubMed 41994523 · doi:10.3389/fpubh.2026.1776405
What was done
Authors conducted a systematic review and random-effects meta-analysis following PRISMA 2020 guidelines, searching PubMed, Embase, Scopus, Web of Science, and Cochrane for observational studies (2000–2024). Eligible studies assessed postnatal bisphenol A (BPA) exposure using validated analytical methods (e.g., LC-MS/MS) and evaluated associations with central precocious puberty or early pubertal outcomes. Quality was evaluated with the Newcastle-Ottawa Scale, heterogeneity by I², and certainty using GRADE.
What was found
Nine studies involving 5,549 participants (predominantly girls) were included. Higher postnatal BPA exposure was observationally associated with increased odds of early pubertal onset (pooled OR = 4.45, 95% CI: 1.69–11.72), with high heterogeneity (I² = 92%). Stronger associations appeared in girls and studies using LC-MS/MS. A dose-response analysis of three studies suggested a 14% increase in odds per 1 μg/L BPA increment. Evidence for boys was limited and inconclusive.
Why it matters
This review synthesizes available epidemiological data linking postnatal endocrine-disrupting plasticizer exposure to premature pubertal onset in girls, supporting continued investigation and regulation of childhood environmental exposures.
Limits
All included studies were observational, with cross-sectional designs precluding causal or temporal conclusions. Heterogeneity was very high (I² = 92%). Data were largely restricted to girls, precluding conclusions in boys, and the dose-response analysis comprised only three studies.
Cited by
- supports BPA and estrogen mimics can cause earlier puberty onset in girls and irregular menstrual cycles in women.