Life course and Lifestyle Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, People's Republic of China.
Epidemiology. 2012 May;23(3):415-22. doi: 10.1097/EDE.0b013e31824d5fd0.
Premature birth is associated with poor metabolic health in both sexes, potentially via earlier pubertal timing.
We examined the associations of gestational age and premature birth (< 37 weeks gestation) with age at onset of puberty (Tanner stage II for breast or genitalia development). We used interval-censored survival analyses in 3963 boys and 3403 girls (93% follow-up) in a population-representative Chinese birth cohort, "Children of 1997," comprising 88% of births in Hong Kong in April and May 1997. We also examined whether the associations varied with sex or with height or body mass index (BMI) at 7 years.
Premature girls reached puberty about 4 months later than girls with ≥ 41 weeks' gestation (time ratio = 1.04 [95% confidence interval = 1.01-1.06]), adjusted for mother' age of menarche, mother's place of birth, and smoking during pregnancy. Gestational age was not associated with onset of puberty in boys (test for interaction by sex, P < 0.01). None of these associations was altered by adjustment for socioeconomic position or varied with childhood height or BMI.
Premature birth was not related to earlier onset of puberty; instead, premature girls had later onset of puberty. Thus, the association between premature birth and subsequent cardiovascular risk is probably not mediated through the timing of pubertal onset. It is unclear whether onset, duration, or tempo of puberty is more relevant to the detrimental consequences of early puberty. Further studies investigating intrauterine, infant, and childhood influences on the duration and tempo of puberty may help unravel the early origins of cardiovascular diseases.
早产与两性的代谢健康不良有关，其潜在机制可能是青春期启动时间提前。
我们通过间隔censored 生存分析，在一个代表性的中国出生队列（“1997 年儿童”）中研究了妊娠年龄和早产（<37 周妊娠）与青春期开始年龄（乳房或生殖器发育的 Tanner Ⅱ期）之间的关系。该队列包含 3963 名男孩和 3403 名女孩（93%的随访率），来自于香港 1997 年 4 月和 5 月的人群代表性出生队列，该队列中 97%的婴儿出生。我们还检验了这些关联是否因性别、7 岁时的身高或体重指数（BMI）而有所不同。
与≥41 周妊娠的女孩相比，早产女孩的青春期启动时间平均晚 4 个月（时间比=1.04[95%置信区间=1.01-1.06]），调整了母亲的初潮年龄、母亲出生地和孕期吸烟状况。性别间的交互检验（P<0.01）表明，妊娠年龄与男孩的青春期启动无关。这些关联均不受社会经济地位调整的影响，也不因儿童身高或 BMI 而异。
早产与青春期启动提前无关；相反，早产女孩的青春期启动时间更晚。因此，早产与随后的心血管风险之间的关联可能不是通过青春期启动时间的改变来介导的。青春期启动、持续时间或速度与早期青春期的不良后果是否更相关仍不清楚。进一步研究宫内、婴儿期和儿童期对青春期持续时间和速度的影响，可能有助于揭示心血管疾病的早期起源。
