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中国重庆一项队列研究:男女孩月经初潮时的母亲年龄与青春期发育时间

Maternal Age at Menarche and Pubertal Timing in Boys and Girls: A Cohort Study From Chongqing, China.

作者信息

Yang Bo, Ostbye Truls, Huang Xin, Li Yueyue, Fang Bo, Wang Hong, Liu Qin

机构信息

School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China.

Department of Family Medicine & Community Health and Duke Global Health Institute, Duke University, Durham, North Carolina.

出版信息

J Adolesc Health. 2021 Mar;68(3):508-516. doi: 10.1016/j.jadohealth.2020.06.036. Epub 2020 Aug 11.

Abstract

PURPOSE

This study explored the association of maternal age at menarche (AAM) with pubertal timing among girls and boys in Chongqing, China.

METHODS

Pubertal development of 1,237 children (542 girls and 695 boys) were examined half-yearly through inspection and palpation from April 2014 to June 2019. Characteristics of parents and maternal AAM were collected by a parental questionnaire at baseline. Maternal AAM was used both as a continuous and a categorical variable in Cox regression models.

RESULTS

A total of 1,198 children (528 girls and 670 boys) were included in the study. In the simple Cox model, earlier maternal AAM was associated with girls' earlier menarche, breast and pubic hair development, and boys' first ejaculation, testicular development, and genital development. When adjusting for children's body mass index z-scores (BMIz) and socioeconomic covariates, we found that girls whose mothers had early AAM had a higher risk of earlier onset of menarche (hazard ratio [HR]: .922, 95% confidence interval [CI]: .852-.998 for continuous maternal AAM, HR: 1.297, 95% CI: 1.041-1.616 for maternal AAM ≤13 years), and boys whose mother achieved menarche earlier experienced a higher risk of earlier onset of first ejaculation (HR: .896, 95% CI: .830-.968). Children's BMIz were related to all nine pubertal milestones. Parental education and relationship, birth weight, parity, and family type were also associated with pubertal timing.

CONCLUSIONS

Earlier maternal AAM was related to earlier pubertal timing in both girls and boys in Chongqing, especially girls' age at menarche and boys' first ejaculation. Children's BMIz was the most consistent factor for pubertal timing. Children's BMIz and socioeconomic conditions had greater influence on most pubertal milestones than maternal AAM.

摘要

目的

本研究探讨了中国重庆地区女孩和男孩的初潮年龄(AAM)与青春期发育时间的关联。

方法

2014年4月至2019年6月期间,通过检查和触诊每半年对1237名儿童(542名女孩和695名男孩)的青春期发育情况进行检查。在基线时通过父母问卷收集父母的特征和母亲的初潮年龄。在Cox回归模型中,母亲的初潮年龄既作为连续变量也作为分类变量使用。

结果

共有1198名儿童(528名女孩和670名男孩)纳入研究。在简单Cox模型中,母亲初潮年龄较早与女孩初潮、乳房和阴毛发育较早,以及男孩首次遗精、睾丸发育和生殖器发育较早相关。在调整儿童的体重指数z评分(BMIz)和社会经济协变量后,我们发现母亲初潮年龄早的女孩初潮提前的风险更高(风险比[HR]:.922,95%置信区间[CI]:.852-.998,母亲初潮年龄为连续变量;HR:1.297,95%CI:1.041-1.616,母亲初潮年龄≤13岁),母亲初潮年龄早的男孩首次遗精提前的风险更高(HR:.896,95%CI:.830-.968)。儿童的BMIz与所有九个青春期发育里程碑相关。父母的教育程度和关系、出生体重、产次和家庭类型也与青春期发育时间有关。

结论

在重庆地区,母亲初潮年龄较早与女孩和男孩青春期发育时间较早相关,尤其是女孩的初潮年龄和男孩的首次遗精。儿童的BMIz是青春期发育时间最一致的因素。儿童的BMIz和社会经济状况对大多数青春期发育里程碑的影响比母亲的初潮年龄更大。

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