Preparing for adulthood--patterns of physical growth, sexual maturity and menarche of adolescent girls in selected urban slums and rural areas.

Adolescent girls are the future mothers. Height less than 145 cm and weight less than 45 kg are considered to be high obstetric risk factor for adverse maternal and perinatal outcome including low birth weight. Teenage pregnancy is another problem in our country. This study aimed to study height and weight of girls of vulnerable urban slums and rural areas. It also studied the pattern of onset of menarche and attainment of sexual maturity in relation to age. The longitudinal, multicentric, descriptive observational study was carried out by the Indian Council of Medical Research during the period of 1986 to 1991 in selected rural (Chandigarh, Hyderabad, Jabalpur, Varanasi, Vellore) and two urban slum areas (Vellore and Delhi) in different regions of India. Girls of ages 10-12 years were followed up till 16 years for their height and weight. Weight increased from 22.3 to 39.4 kg in rural and 23.4 to 41.9 kg in urban areas from 10 to 16 years. Height increased from 126.2 cm to 150.2 cm in rural and 128.2 to 153.0 cm in urban areas. Large variations from centre to centre were observed in ages for appearance of sexual characteristic and the order in which these appeared. Pubic hair was the first sexual characteristic to appear in majority of the girls in all the centres. The mean age at stages II, III and IV of breast development in girls varied between 11.3 to 12.3 years, 12.3 to 13.2 years and 13.3 to 14.1 years respectively. The percentage of girls who had attained menarche by the age of 15 years, ranged from 30 to 100 per cent between centres. Those children in whom the sexual characteristics had appeared earlier than others had higher mean body weight and height as compared to others at the same age points. The data on physical growth parameters during adolescence revealed that girls from rural areas, were shorter and weighed less compared to those from urban slums. Adolescent girls are undernourished in urban slums and rural areas.