The incidence of precocious puberty (PP) in Chinese children is increasing year by year, precocious children are more likely to have physical and mental health problems than normal children, and their growth can be affected. In view of the current clinical lack of understanding and prevention measures for PP, it's of great significance to clarify the relevant influencing factors and provide references for the prevention and treatment of PP.

To systematically evaluate the factors associated with PP in Chinese children.

We searched PubMed, Web of Science, Embase, Cochrane Library, CBM, CNKI, VIP and Wanfang databases, the search period was from the establishment of the database to April 30, 2024. Two researchers independently screened the literature, extracted data and assessed the quality of the included literature, and we performed Meta-analysis using Stata 15.0 software.

A total of 41 studies covering 44 221 cases were selected, and 31 influencing factors were extracted. Methodological quality evaluation of the literature shows that 20 medium-quality and 21 high-quality studies were included. Meta-analysis demonstrated that: female (OR=1.64) , urban settlement (OR=4.13) , residential near chemical industry park (OR=2.52) , maternal age at menarche≤12 years old (OR=2.37) , >12-14 years old (OR=3.04) , low parental education (OR=2.41) , poor parental relationship (OR=4.37) , parental companionship <0.5 years (OR=2.05) , screen time (OR=3.07) , love romantic films and novels (OR=5.94) , outdoor activity<1 h/d (OR=3.86) , sleep with the light on (OR=2.48) , use of adult chemical products (OR=5.36) , plastic products are often used at home (OR=2.45) , heavy school workload (OR=2.63) , family history of PP (OR=3.23) , high BMI (OR=1.57) , sleep duration (OR=2.57) , frequent consumption of nutritional supplements (OR=3.01) , high-calorie and high-fat diets (OR=3.05) , high protein diets (OR=2.47) , animal food (OR=3.35) , sweets (OR=5.85) , food containing pigments or preservatives (OR=1.80) , leptin (OR=5.34) , estradiol (OR=3.32) , luteinizing hormone (OR=3.71) , insulin-like growth factor 1 (OR=2.70) and follicle stimulating hormone (OR=2.40) levels were the main risk factors for PP in Chinese children (P<0.05) , whereas maternal age at menarche >14 years (OR=0.64) , outdoor activity ≥2 h/d (OR=0.73) and consumption of vegetables and fruits ≥200 g/d (OR=0.60) were protective factors (P<0.05) .

Our findings show that the occurrence of PP in Chinese children is influenced by a multitude of sociodemographic, psychosocial, genetic, physiological, dietary, and environmental factors, among which the later age of mother´s menarche, the longer outdoor activities and the consumption of vegetables and fruits ≥200 g/d are protective factors. In the future, it is necessary to investigate and intervene on controllable factors. Families, schools and hospitals can work together to avoid or reduce the occurrence of PP in children.

我国儿童性早熟发生率逐年上升，性早熟儿童比正常儿童更易出现身心健康问题，正常生活成长受到影响。目前临床对于性早熟的认识及防治措施尚不足，明确相关影响因素，为开展性早熟的防治工作提供参考具有重要意义。

通过Meta分析探讨中国儿童发生性早熟的影响因素。

计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国生物医学文献数据库、中国知网、维普网、万方数据知识服务平台中有关于中国儿童性早熟影响因素的相关文献，检索时间设置为建库至2024-04-30。由2名研究人员独立筛选文献，并对纳入文献进行数据提取和质量评价，使用Stata 15.0软件进行Meta分析。

最终纳入41篇文献，总样本量为44 221例，共提取到31个影响因素。文献方法学质量评价结果：中等质量文献20篇，高质量文献21篇。Meta分析结果显示，女性（OR=1.64）、居住城市（OR=4.13）、居住化工园区附近（OR=2.52）、母亲初潮年龄≤12岁（OR=2.37）及>12~14岁（OR=3.04）、父母学历低（OR=2.41）、父母关系不和睦（OR=4.37）、父母陪伴时长<0.5年（OR=2.05）、视屏时间>2 h/d（OR=3.07）、喜爱言情类作品（OR=5.94）、户外活动时长<1 h/d（OR=3.86）、开灯睡觉（OR=2.48）、使用成人化学用品（OR=5.36）、家中常用塑料制品（OR=2.45）、课业负担重（OR=2.63）、性早熟家族史（OR=3.23）、高BMI（OR=1.57）、睡眠时长≤8 h/d（OR=2.57）、常食用营养滋补品（OR=3.01）、高热量高脂饮食（OR=3.05）、高蛋白饮食（OR=2.47）、动物性食品（OR=3.35）、喜食甜食（OR=5.85）、含色素或防腐剂食品（OR=1.80）、瘦素（OR=5.34）、雌二醇（OR=3.32）、黄体生成素（OR=3.71）、胰岛素样生长因子1（OR=2.70）、促卵泡生成素（OR=2.40）水平升高是中国儿童性早熟的主要危险因素（P<0.05）；而母亲初潮年龄>14岁（OR=0.64）、户外活动时长≥2 h/d（OR=0.73）及食用蔬菜水果≥200 g/d（OR=0.60）是中国儿童性早熟的保护因素（P<0.05）。

现有研究证据表明，中国儿童发生性早熟受社会人口学因素、社会心理学因素、遗传因素、生理因素、饮食因素和环境因素的多元影响，其中母亲初潮年龄较晚、户外活动时长越长和食用蔬菜水果≥200 g/d为保护因素。今后需要针对可控因素进行调查与干预，家庭、学校及医院可共同配合，避免或减少儿童性早熟的发生。