Screen time and pubertal development: a systematic review and meta-analysis.

Abstract

Background: Several mechanisms have been proposed to explain how screen time may affect pubertal development.

Aim: To quantify the association between screen time exposure and timing of pubertal onset in children.

Subjects and methods: We conducted a systematic review and random-effects meta-analysis of observational studies identified through PubMed, Embase, and the Cochrane Library up to 1 May 2025. Pooled odds ratios (ORs) for early or precocious puberty per additional hour of screen time and for categorical comparisons (≥ 2 vs < 2 h/day) were estimated, along with weighted mean differences (WMDs) in daily screen hours.

Results: Of 1,284 unique records, 10 studies enrolling 97,898 children aged 2-19 years met inclusion criteria, most conducted in China. Each additional hour of screen exposure was associated with higher odds of early pubertal development (OR = 1.35; 95% CI = 1.05-1.73). The comparison of ≥ 2 vs < 2 h/day did not reach significance (1.07; 95% CI = 0.90-1.26). In girls, pooled ORs were 1.07 (95% CI = 0.84-1.37) for early puberty and 1.27 (95% CI = 0.85-1.90) for precocious puberty. Children experiencing early puberty spent on average 0.63 additional screen-hours per day compared with peers (WMD = 0.63 h; 95% CI = 0.24-1.02).

Conclusions: Screen time is associated with pubertal onset in both boys and girls, although substantial heterogeneity and cross-sectional designs limit causal inference. Future longitudinal and experimental studies are needed to clarify underlying mechanisms and inform evidence-based guidelines for healthy pubertal development.