Prevalence of constitutional delay of growth and puberty in adolescents with short stature: a systematic review and meta-analysis

Abstract

Constitutional Delay of Growth and Puberty (CDGP) is the most common cause of delayed puberty and a prevalent complaint in pediatric endocrinology, often associated with short stature in adolescence. This systematic review and meta-analysis aimed to synthesize the available evidence to estimate the prevalence of CDGP in this population. Following PRISMA guidelines, searches were conducted across multiple databases with no initial date restriction. Observational studies reporting the proportion of CDGP in adolescents with short stature were included. The quantitative synthesis used a random-effects model. Ten studies, totaling 1,516 participants, met the criteria. The pooled prevalence of delayed puberty was 69.7% (95% CI: 23.8% to 94.4%). However, heterogeneity among studies was extremely high (I² = 98.5%), and the confidence interval is wide, reflecting substantial uncertainty. Subgroup analyses indicated that age range, diagnostic criteria, and, most importantly, selection bias in referral settings are the main sources of this variation. It is concluded that the reported prevalence of CDGP is highly variable and contingent on clinical context and methodological definitions, not representing a robust population estimate. Future studies with standardized criteria and more diverse populations are needed.