INCREASED PERINATAL INTRACRANIAL-PRESSURE AND PREDICTION OF EARLY PUBERTY IN GIRLS WITH MYELOMENINGOCELE

An increased risk of developing precocious puberty has been reported i n children with myelomeningocele. In order to evaluate this further an d to study factors associated with early or precocious puberty the med ical records of all girls with myelomeningocele, born from 1970 onward s (n=64), who were admitted to our unit were reviewed. Early/precociou s puberty (E/PP) was defined as breast development or pubic hair corre sponding to Tanner stage 2 before the age of 9.2 years. In 32 out of 6 4 cases data were sufficient for evaluation of the timing of puberty. Twenty girls had E/PP and 12 girls normal timing of puberty. In the gi rls who had reached the age of 9.2 years the incidence of E/PP was at least 52%. Girls with E/PP had a higher incidence of hydrocephalus, we re treated with intraventricular shunts more often, and had significan tly higher frequency of increased intracranial pressure during the per inatal period (p < 0.05, p < 0.01, and p < 0.001, respectively). The g roup of girls developing E/PP was also more severely disabled with res pect to motor and urological function and had more shunt revisions. In conclusion, E/PP in girls with myelomeningocele is strongly associate d with increased intracranial pressure particularly during the perinat al period.