Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
The JiVitA Project, Gaibandha, Bangladesh.
PLoS One. 2021 Apr 2;16(4):e0247762. doi: 10.1371/journal.pone.0247762. eCollection 2021.
This study aimed to describe the timing and patterns of pubertal maturation of girls living in rural Bangladesh. Starting in September 2015, a total of 15,320 girls from a birth cohort, aged 9 to 15 years at initial encounter, were visited twice at about a one year interval, typically in their birth month. Participants were asked to self-report extent of pubertal maturation, including breast development, pubic hair growth and age at menarche, if applicable. Pubertal stage (abbreviated as B2 and B3-4 for breast development and PH2 and PH3-4 for pubic hair growth) was assigned. Data from both visits were pooled, yielding a total of 29,377 age-related observations per pubertal characteristic. Probit regression models were used to estimate distributions of age at which each stage of pubertal development was attained. Before age 8, <3% of the study population initiated pubertal maturation as indicated by onset of breast development (B2). The median (95% confidence interval) age of B2 and B3-4 was 11.02 (11.00-11.04) and 12.82 (12.80-12.83) years, respectively; and 12.93 (12.91-12.94) and 14.29 (14.27-14.31) years for the onset (PH2) and advanced stage (PH3-4) of pubic hair growth, respectively. Median age at menarche was 13.17 (13.15-13.19) years, with 2.15 years of timespan from B2 to menarche. Girls in rural Bangladesh progressed through puberty following a well-documented sequence of sexual maturation stages. The age at which each pubertal milestone took place was somewhat later, but the tempo from breast development to menarche was comparable to that observed elsewhere. Our findings present a current norm of pubertal maturation in a typical, rural adolescent population in South Asia, which could help inform future studies and interventions to preserve or improve early adolescent health and development.
本研究旨在描述孟加拉国农村地区女孩青春期发育的时间和模式。从 2015 年 9 月开始，一个出生队列中的 15320 名女孩，在初次接触时年龄为 9 至 15 岁，每一年左右进行两次访问，通常在出生月份进行。参与者被要求自我报告青春期发育的程度，包括乳房发育、阴毛生长和初潮年龄（如果适用）。根据乳房发育（缩写为 B2 和 B3-4）和阴毛生长（缩写为 PH2 和 PH3-4）阶段分配。将两次访问的数据合并，得到每个青春期特征的总共 29377 个与年龄相关的观察值。使用概率回归模型估计每个青春期发育阶段达到的年龄分布。在 8 岁之前，<3%的研究人群开始青春期发育，表现为乳房发育（B2）的开始。B2 和 B3-4 阶段的中位数（95%置信区间）年龄分别为 11.02（11.00-11.04）和 12.82（12.80-12.83）岁；阴毛生长开始（PH2）和高级阶段（PH3-4）的中位数年龄分别为 12.93（12.91-12.94）和 14.29（14.27-14.31）岁。初潮年龄的中位数为 13.17 岁（13.15-13.19），从 B2 到初潮的时间跨度为 2.15 年。孟加拉国农村地区的女孩按照性成熟阶段的既定顺序经历青春期。每个青春期里程碑发生的年龄稍晚，但从乳房发育到初潮的时间进程与其他地方观察到的相似。我们的研究结果呈现了南亚典型农村青少年群体青春期成熟的当前规范，这有助于为未来研究和干预措施提供信息，以保护或改善青少年早期的健康和发展。
