Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, RS, Brasil.
Rev Saude Publica. 2010 Apr;44(2):249-60. doi: 10.1590/s0034-89102010000200004.
To examine the relationship between growth patterns in early childhood and the onset of menarche before age 12.
The study included 2,083 women from a birth cohort study conducted in the city of Pelotas, Southern Brazil, starting in 1982. Anthropometric, behavioral, and pregnancy-related variables were collected through home interviews. Statistical analyses were performed using Pearson's chi-square and chi-square test for linear trends. A multivariable analysis was carried out using Poisson regression based on a hierarchical model.
Mean age of menarche was 12.4 years old and the prevalence of menarche before age 12 was 24.3%. Higher weight-for-age, height-for-age, and weight-for-height z-scores at 19.4 and 43.1 months of age were associated with linear tendencies of increased prevalence and relative risks of the onset of menarche before age 12. Girls who experienced rapid growth in weight-for-age z-score from birth to 19.4 months of age and in weight-for-age or height-for-age z-scores from 19.4 to 43.1 months of age also showed higher risk of menarche before age 12. Higher risk was seen when rapid growth in weight-for-age z-score was seen during these age intervals and the highest risk was found among those in the first tertile of Williams' curve at birth. Rapid growth in weight-for-height z-score was not associated with menarche before age 12.
Menarche is affected by nutritional status and growth patterns during early childhood. Preventing overweight and obesity during early childhood and keeping a 'normal' growth pattern seem crucial for the prevention of health conditions during adulthood.
探讨儿童早期生长模式与 12 岁前初潮的关系。
该研究纳入了巴西南部城市佩洛塔斯（Pelotas）出生队列研究中的 2083 名女性，研究始于 1982 年。通过家庭访谈收集了人体测量、行为和与妊娠相关的变量。采用 Pearson's χ2 检验和线性趋势 χ2 检验进行统计分析。采用基于分层模型的泊松回归进行多变量分析。
初潮平均年龄为 12.4 岁，12 岁前初潮的发生率为 24.3%。19.4 个月和 43.1 个月时体重与年龄比、身高与年龄比和体重与身高比 z 分数较高与 12 岁前初潮发生率的线性趋势和相对风险增加有关。出生至 19.4 个月体重与年龄比 z 分数快速增长、19.4 至 43.1 个月体重与年龄比或身高与年龄比 z 分数快速增长的女孩初潮前的风险也较高。在这些年龄间隔内体重与年龄比 z 分数快速增长且出生时处于威廉姆斯曲线第 1 三分位数的女孩风险最高。体重与身高比 z 分数快速增长与 12 岁前初潮无关。
初潮受儿童早期营养状况和生长模式的影响。预防儿童早期超重和肥胖，保持“正常”的生长模式，对预防成年期健康状况至关重要。
