Department of General Pediatrics, Boston University School of Medicine, Boston, MA, USA.
Ann Epidemiol. 2012 Oct;22(10):731-7. doi: 10.1016/j.annepidem.2012.08.005. Epub 2012 Sep 5.
To determine the role of type, timing, and cumulative childhood hardships on age at menarche in a prospective cohort study.
A longitudinal analysis was undertaken of 4524 female participants of the National Child Development Study cohort (1958-2003). Six types of childhood hardships were identified with a factor analysis methodology. Paternal absence/low involvement in childhood was an a priori hardship. Retrospective reports of abuse in childhood also were explored in relation to age at menarche. Generalized logit regression analyses explored the impact of type, timing, and cumulative hardships on age at menarche (≤ 11, 12-13, ≥ 14 years).
Cumulative childhood hardships were associated with a graded increase in risk for later menarche with adjusted odds ratio [AOR] of 1.37 (95% confidence interval [95% CI], 1.10-1.70), 1.50 (95% CI, 1.18-1.91), and 1.58 (95% CI, 1.29-1.92) among those with two, three, and four or more adversities, respectively. More than two hardships in early life had the strongest association with late menarche (AOR, 2.32; 95% CI, 1.12-4.80). Sexual abuse was most strongly associated with early menarche (AOR, 2.60; 95% CI, 1.40-4.81).
Cumulative childhood hardships increased risk for later age at menarche. Child abuse was associated with both early and late menarche, although associations varied by type of abuse.
在一项前瞻性队列研究中,确定类型、时间和累积儿童期逆境对初潮年龄的作用。
对英国国民儿童发展研究队列(1958-2003 年)的 4524 名女性参与者进行了纵向分析。采用因子分析方法确定了六种类型的儿童期逆境。父亲在儿童期的缺失/低参与度是一个预先确定的逆境。还探讨了儿童期虐待的回顾性报告与初潮年龄的关系。广义逻辑回归分析探讨了类型、时间和累积逆境对初潮年龄(≤11、12-13、≥14 岁)的影响。
累积儿童期逆境与初潮年龄较晚呈梯度相关,调整后的优势比(AOR)分别为 1.37(95%置信区间[95%CI],1.10-1.70)、1.50(95%CI,1.18-1.91)和 1.58(95%CI,1.29-1.92),在分别有两种、三种和四种或更多逆境的人群中。生命早期有两种以上逆境与初潮较晚的相关性最强(AOR,2.32;95%CI,1.12-4.80)。性虐待与初潮最早发生的相关性最强(AOR,2.60;95%CI,1.40-4.81)。
累积儿童期逆境增加了初潮年龄较晚的风险。儿童虐待与初潮早、晚均有关,但其关联因虐待类型而异。