Peer-reviewed article
Growth in Infancy and Childhood and Age at Menarche in Five Low- or Middle-Income Countries: Consortium of Health Orientated Research in Transitional Societies (COHORTS)
Lukhanyo H. Nyati, Shane Anthony Norris, Lisa Kim Micklesfield, Linda S. Adair, Caroline H. D. Fall et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how birth weight and childhood growth patterns affect the age when girls reach menarche (first menstruation) across five low- and middle-income countries. Data from nearly 4,000 girls in Brazil, Guatemala, India, the Philippines, and South Africa showed that taller and heavier girls at 24 months and mid-childhood reached menarche earlier, while girls with stunting (severe growth shortfalls) reached menarche later. Birth weight alone did not predict menarche age. The findings suggest that rapid growth and excess weight gain in childhood may accelerate reproductive development.
Key points
- Mean age at menarche was 12.8 years across the five countries
- Girls who were taller at 24 months and mid-childhood had increased likelihood of early-onset menarche (odds ratios 1.35 and 1.32)
- Girls who were heavier at 24 months and mid-childhood had increased likelihood of early-onset menarche (odds ratios 1.15 and 1.18)
- Stunted girls reached menarche 7 months later than non-stunted girls
- Birth weight alone was not associated with age at menarche
Limitations
This is an observational study examining associations between childhood growth and menarche timing; it cannot establish causation or explain the mechanisms linking growth patterns to reproductive development. The study does not address potential confounding factors such as nutrition quality, environmental factors, or genetic influences on both growth and menarche timing.
Abstract
BACKGROUND: Earlier age at menarche is associated with behavioral and noncommunicable disease risks. The influence of birth weight (BW) (intrauterine) and postnatal growth on age at menarche is not well studied in low- and middle-income countries (LMICs). OBJECTIVE: Therefore, we investigated these associations in 5 LMIC birth cohorts. METHODS: We analyzed data from Brazil, Guatemala, India, the Philippines, and South Africa (n = 3983). We derived stunting (< -2 SD scores) at 24 mo using the WHO child growth standards. We generated interaction terms with categorized BW and conditional weight (lighter < 0 or heavier ≥ 0), and height (shorter < 0 or taller ≥ 0) z-scores. We categorized early-, modal-, and late-onset menarche and used multilevel ordinal regression. We used multilevel linear regression on continuous age at menarche. RESULTS: Mean age at menarche was 12.8 y (95% CI: 12.7 12.9). BW was not associated with age at menarche. Conditional height at 24 mo and mid-childhood (OR: 1.35; 95% CI: 1.27, 1.44 and 1.32; 1.25, 1.41, respectively) and conditional weight at 24 mo and mid-childhood (OR: 1.15; 1.08, 1.22 and 1.18; 1.11, 1.25, respectively) were associated with increased likelihood of early-onset menarche. Being heavier at birth and taller at 24 mo was associated with a 4-mo (95% CI: 0.8, 7.6) earlier age at menarche than being lighter at birth and shorter at 24 mo. Being heavier at birth but lighter in mid-childhood was associated with a 3-mo (95% CI: 0.8, 4.8) later age at menarche than being lighter at birth and mid-childhood. Age at menarche was 7 mo later in stunted than nonstunted girls. CONCLUSION: Age at menarche is inversely related to relative weight gain but also to rapid linear growth among those born shorter but remained stunted, and those born taller and grew excessively. These findings do not deter the global health goal to reduce growth faltering but emphasize the potential adverse effects of an obesogenic environment on adolescent development.