Association Between Age at Menarche and Early-Life Nutritional Status in Rural Bangladesh

Abstract

Summary. Age at menarche is associated with anthropometry in adolescence. Recently, there has been growing support for the hypothesis that timing of menarche may be set early in life but modified by changes in body size and composition in childhood. To evaluate this, a cohort of 255 girls aged <5 years recruited in 1988 were followed up in 2001 in Matlab, Bangladesh. The analysis was based on nutritional status as assessed by anthropometry and recalled age at menarche. Data were examined using lifetable techniques and the Cox regression model. The association between nutritional status indicators and age at menarche was examined in a multivariate model adjusting for potential confounding variables. Censored cases were accounted for. The median age at menarche was 15·1 years. After controlling for early-life predictors (birth size, childhood underweight, childhood stunting) it appeared that adolescent stunting stood out as the most important determinant of age at menarche. Adolescent stunting still resonates from the effect of stunting in early childhood (OR respectively 2·63 (p<0·01 CI: 1·32-5·24) and 8·47 (p<0·001 CI: 3·79-18·93) for moderately and severely stunted under-fives as compared with the reference category). Birth size was not a significant predictor of age at menarche. It is concluded that age at menarche is strongly influenced by nutritional status in adolescence, notably the level of stunting, which is in turn highly dependent on the level of stunting in early childhood. A 'late' menarche due to stunting may be detrimental for reproductive health in case of early childbearing because of the association between height and pelvic size.

Age at menarche and body mass index (BMI) among adolescent secondary school girls in Port Harcourt, Nigeria

“…Other authors in Nigeria 10,18,20 and India 8 have also shown an inverse relationship between height and age at menarche. Bosch et al 32 in Matlab, Bangladesh found that adolescent stunting stood out as the most important determinant of age at menarche.…”

Human Capital Investment and the Gender Division of Labor in a Brawn-Based Economy

“…If age at menarche is higher for women with a larger body mass endowment, this could explain the sign reversal, relative to men, for the estimated body mass effects on schooling. The medical literature, however, suggests that age at menarche is negatively related to body mass in poor countries (Khah et al, 1995), including specifically Bangladesh (Bosch et al, 2008). We can use our panel data to estimate directly the association between the body mass endowment and age at menarche.…”

Human Capital Investment and the Gender Division of Labor in a Brawn-Based Economy

“…If age at menarche is higher for women with a larger body mass endowment, this could explain the sign reversal, relative to men, for the estimated body mass effects on schooling. The medical literature, however, suggests that age at menarche is negatively related to body mass in poor countries (Khah et al , 1995), including specifically Bangladesh (Bosch et al , 2008). We can use our panel data to estimate directly the association between the body mass endowment and age at menarche.…”