Association of Early Menarche with Adolescent Health in the Setting of Rapidly Decreasing Age at Menarche

Abstract

Study Objective: This study aimed to investigate the association between age at menarche (AAM) and adverse health indicators in adolescent girls. Design: A retrospective cohort study. Setting: Population-based survey data. Participants: A total of 319,437 female participants aged 12-18 years from the Korea Youth Risk Behaviour Web-based Survey. Interventions and Main Outcome Measures: We assessed associations between AAM (categorized as #10, 11, and $12) and health indicators (poor self-rated health, high psychological stress, unhappiness, sexual initiation, and pregnancy). Covariates were individual-level (bodyweight, living with family, parent's education, household wealth, and presence of parents and siblings) and community-level factors (year of birth, single-sex education and level of school, urbanization level of school area, year of survey, and regional deprivation). Odds ratios (ORs) for each adverse health indicator were examined by each AAM group using multivariable regression analyses. For pregnancy, we calculated relative risks (RRs) using a log-binomial regression model. Results: Age at menarche was !12 in 42% of our study population. Nearly one-half of the girls born in the early 2000s went through menarche before the age of 12 years, whereas only one-third of girls born in the early 1990s went through menarche before the age of 12 years. Girls who experienced menarche at age #10 or age 11 years were more likely to show self-rated poor health

Early physical maturation and subjective health complaints in adolescent girls: a pooled cross-sectional analysis

“…We derived the menarcheal status from the question: ‘Have you begun to menstruate (have periods)?’ with possible answers: ‘No, I haven’t yet’ or ‘Yes, I have at the age of __years and __months’. We applied a recommended cut-off age of 11 years to identify early age at menarche24 25 and tested its sensitivity by replicating the analysis using a later cut-off age of 12 years 25 26…”

A secular trend in age at menarche in Yunnan Province, China: a multiethnic population study of 1,275,000 women

“…Many Mendelian randomization studies have shown a potential effect of earlier AAM on a broad range of health-related traits [60][61][62][63]. AAM less than 12 years can be considered as an indicator in adolescent health interventions [64]. Given the robust correlation between early AAM and women's health risks, the trend of AAM in the previous study provides an alert to health authorities, and women's health management should be adjusted to respond to the related disease threat.…”

Land use and semen quality: A fertility center cohort study

“…We included individual characteristics such as age (categorized as 20s, 30s, 40s and 50s), BMI (< 23, 23–24.99, 25–29.99, and ≥ 30 kg/m 2 ) based on the criteria for Asian populations [ 26 ], occupation (2 groups), current smoking (yes or no), season (Mar-May, Jun-Aug, Sep-Nov, Dec-Feb), and clustering effect of district (‘ gu ’, n = 68) in a generalized estimating equation to adjust for potential confounding effects. We did not include air pollution and regional deprivation index because the analytic model of this study included administrative district of home address, which is also the basis of estimation of exposure to air pollution [ 17 , 27 ], noise [ 28 ], and deprivation index [ 29 ]. In addition, residential proximity to major roadways can be used as a proxy for exposure to traffic-related air pollutants, noise, and other spatial characteristics [ 30 – 32 ].…”