Romans S E, Martin J M, Gendall K, Herbison G P
Centre for Research in Women's Health, University of Toronto, Toronto, Ontario, Canada.
Psychol Med. 2003 Jul;33(5):933-9. doi: 10.1017/s0033291703007530.
The goal of this study was to determine associations between the age of first menstrual period (menarche) and adverse childhood experiences in a random community sample of New Zealand women. Previous reports have linked early menarche to absence of a live-in father figure and to family conflict, as well as genetic determination of early puberty and adiposity.
Two groups of women randomly selected from the community on their responses to a mailed screening questionnaire on childhood sexual abuse (CSA) were interviewed in detail. Data about their childhood experiences, including age of menarche, were collected on two occasions, 6 years apart. Early menarche was defined as first menstruation occurring before the age of 12 years.
Univariate analyses identified a number of adverse childhood experiences preceded early menarche, which was reported by 20.3% of this sample. These included low family socio-economic status, absence of father, a number of variables showing family conflict, poor relationships between the girl and either/both parents, a self-rated childhood personality style as a loner, childhood physical and sexual abuse. Sequential modelling showed parental rows, being a loner and the duration of CSA to be most important, although lack of a father and any CSA were each also independently associated with early menarche. No variables survived the modelling exercise as predictors of early menarche for those women who did not report childhood sexual abuse.
The identified variables statistically interacted with each other in a highly complex manner. The attempt to rank their importance was only partially successful, for methodological reasons (half the sample reporting CSA). Chronic or protracted CSA needs to be added to the list of factors associated with early menarche in future studies.
本研究的目的是在新西兰女性的随机社区样本中确定初潮年龄与童年不良经历之间的关联。先前的报告已将初潮提前与缺乏常住父亲形象、家庭冲突以及青春期早熟和肥胖的遗传决定因素联系起来。
根据她们对一份关于童年性虐待（CSA）的邮寄筛查问卷的回答，从社区中随机选择两组女性进行详细访谈。在相隔6年的两个时间点收集了她们童年经历的数据，包括初潮年龄。初潮提前定义为首次月经发生在12岁之前。
单因素分析确定了初潮提前之前的一些童年不良经历，该样本中有20.3%的女性报告了初潮提前。这些经历包括家庭社会经济地位低、父亲缺失、一些显示家庭冲突的变量、女孩与父母一方或双方关系不佳、自评童年性格为孤独者、童年身体虐待和性虐待。序贯建模显示父母争吵、孤独性格和CSA持续时间最为重要，尽管父亲缺失和任何CSA各自也与初潮提前独立相关。对于那些未报告童年性虐待的女性，没有变量在建模分析中作为初潮提前的预测因素留存下来。
所确定的变量以高度复杂的方式在统计上相互作用。由于方法学原因（样本中有一半报告了CSA），试图对它们的重要性进行排序仅部分成功。在未来的研究中，需要将慢性或长期的CSA添加到与初潮提前相关的因素列表中。
