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Maternal attitude towards delaying puberty in girls with and without a disability: a questionnaire-based study from the United Arab Emirates
  1. Asma Deeb1,
  2. Mariette Akle1,
  3. Abrar Al Zaabi1,
  4. Zohra Siwji1,
  5. Salima Attia1,
  6. Hana Al Suwaidi1,
  7. Nabras Al Qahtani1,
  8. Sarah Ehtisham2
  1. 1 Paediatric Endocrinology Department, Mafraq Hospital, Abu Dhabi, United Arab Emirates
  2. 2 Paediatric Department, Mediclinic City Hospital, Dubai, N/A, United Arab Emirates
  1. Correspondence to Dr Asma Deeb; adeeb{at}


Background Parental anxiety about the impact of puberty/menses, particularly in girls with severe disability leads to seeking therapeutic pubertal suppression. We aim to explore maternal attitudes and reasons for seeking pubertal suppression.

Methods Mothers of girls receiving gonadotropin -releasing hormone analogue therapy in Mafraq hospital, Abu Dhabi were enrolled in the study. A semistructured interview was conducted to ascertain possible reasons for delaying puberty. The study group was divided into girls with a disability with central precocious puberty (CPP) or normal puberty and girls without a disability presenting with CPP.

Results 42 mother–daughter pairs were enrolled and divided into two groups; group A: 15 girls with CPP with no disability; group B: 27 girls with disability (10 had CPP (group B1) and 17 had normal pubertal timing (group B2)). Mothers in group A aimed to delay puberty, while in group B, 13 (48%) mothers desired to halt puberty and 7 (26%) requested permanent surgical intervention. Fear of short stature (15, 100%), inability to cope psychologically (10, 67%) and fear of peer rejection (9, 60%) were the main concerns in group A. In group B, mothers were concerned about menstrual hygiene management (25, 92.5%), fear of child abuse or unwanted pregnancy (15, 55%) and fear of inability to express pain/discomfort with menstruation (8, 30%).

Conclusion Mothers of girls with a disability commonly seek medical help to delay/halt puberty due to concerns about menstrual hygiene. Short final height was the main concern for girls without a disability. Culture and religion play an important role in puberty management in girls with a disability.

  • puberty
  • disability
  • gonadotropin releasing hormone analogue
  • menstruation

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  • Contributors AD: designed the study, applied for ethical approval and wrote the manuscript. MA: designed the questionnaire and interviewed the study participants. AAZ and ZS: collected patients’ data and collated the results. SA, HAS and NAQ: clinicians who recruited the study subjects. SE: revised the study proposal, advised on the questionnaire design and revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval Mafraq Hospital Research and Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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