TY - JOUR
T1 - Association between age at menarche and early-life nutritional status in rural Bangladesh
AU - Bosch, Alinda M.
AU - Willekens, Frans J.
AU - Baqui, Abdullah H.
AU - Van Ginneken, Jeroen K.S.
AU - Hutter, Inge
N1 - Funding Information:
This research was supported by the Netherlands Foundation for the Advancement of Tropical Research (WOTRO) and its completion was achieved through financial support from the Netherlands Interdisciplinary Demographic Institute (NIDI) and the Population Research Centre (PRC) of Groningen University, for which the authors are most grateful. The authors sincerely acknowledge the contribution of the staff of the Centre for Health and Population Research (ICDDR,B) in Dhaka and Matlab. In particular, they are indebted to Mr Chakraborty, Mrs Khaleda Khanam, Dr Kim Streatfield and Dr Abbas Bhuiya. They also thank Dr Sjoerd Elias of the University Medical Center Utrecht for his valuable comments.
PY - 2008/3
Y1 - 2008/3
N2 - 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.
AB - 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.
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U2 - 10.1017/S0021932007002490
DO - 10.1017/S0021932007002490
M3 - Article
C2 - 17956652
AN - SCOPUS:38349091378
SN - 0021-9320
VL - 40
SP - 223
EP - 237
JO - Journal of Biosocial Science
JF - Journal of Biosocial Science
IS - 2
ER -