Growth in infancy and childhood and age at menarche in five low- or middle-income countries: Consortium of Health Orientated Research in Transitional Societies (COHORTS)
Growth in infancy and childhood and age at menarche in five low- or middle-income countries: Consortium of Health Orientated Research in Transitional Societies (COHORTS)
Background: earlier age at menarche is associated with behavioural and noncommunicable disease risks. The influence of birthweight (intrauterine) and postnatal growth on age at menarche is not well studied in low- and middle-income countries (LMIC), OBJECTIVE: Therefore, we investigated these associations in five LMIC birth cohorts.
Methods: we analysed data from Brazil, Guatemala, India, the Philippines, and South Africa (n=3983). We derived stunting (<-2 SDS) at 24mo using the WHO child growth standards. We generated interaction terms with categorised birthweight and conditional weight (lighter<0 or heavier=>0), and height (shorter<0 or taller=>0) z-scores. We categorised early-, modal- and late-onset menarche and used multilevel ordinal regression. We used multilevel linear regression on continuous age at menarche.
Results: mean age at menarche was 12.8y (95% CI: 12.7 - 12.9). Birthweight was not associated with age at menarche. Conditional height at 24mo and mid-childhood (OR 1.35; 95% CI 1.27-1.44 & 1.32; 1.25-1.41, respectively) and conditional weight at 24mo and mid-childhood (OR 1.15; 1.08-1.22 & 1.18; 1.11-1.25, respectively) were associated with increased likelihood of early-onset menarche. Being heavier at birth and taller at 24mo was associated with a 4-month (95% CI 0.8-7.6) earlier age at menarche than being lighter at birth and shorter at 24mo. Being heavier at birth but lighter in mid-childhood was associated with a 3-month (95% CI 0.8-4.8) later age at menarche than being lighter at birth and mid-childhood. Age at menarche was 7mo later in stunted than non-stunted girls.
Conclusion: age at menarche is inversely related to relative weight gain but also to rapid linear growth among those born shorter but remained stunted, and those born taller and grew excessively. These findings do not deter the global health goal to reduce growth faltering but emphasise the potential adverse effects of an obesogenic environment on adolescent development.
age at menarche, birth cohort, infant, linear growth, low- and middle-income countries, obesity, weight gain
2736-2743
Nyati, L.H.
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Norris, S.A.
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Micklesfield, L.K.
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Adair, L.
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Fall, C.
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Lee, N.
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Martorell, R.
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Osmond, C.
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Richter, L.M.
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Sachdev, H.S.
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Horta, B.
c1c0cf75-59af-47f3-8e02-20297f95bc1f
Stein, A.D.
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September 2023
Nyati, L.H.
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Norris, S.A.
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Micklesfield, L.K.
e73dd95b-ce79-4dc4-b0be-a8935eb069c8
Adair, L.
77c37ed0-84f6-4ada-91f6-0f8c50b6b48a
Fall, C.
7171a105-34f5-4131-89d7-1aa639893b18
Lee, N.
6e13d674-039f-4d6b-8526-9d60f0c8d583
Martorell, R.
9ee73323-0528-4eff-93e3-c96fb1067356
Osmond, C.
2677bf85-494f-4a78-adf8-580e1b8acb81
Richter, L.M.
2a818b1f-3798-4e6e-841d-c19bbb74bac2
Sachdev, H.S.
86c675fa-f58e-4a76-bf55-0972435519ab
Horta, B.
c1c0cf75-59af-47f3-8e02-20297f95bc1f
Stein, A.D.
5ee08d0c-2313-4d74-bfcf-49e9bfabc36d
Nyati, L.H., Norris, S.A., Micklesfield, L.K., Adair, L., Fall, C., Lee, N., Martorell, R., Osmond, C., Richter, L.M., Sachdev, H.S., Horta, B. and Stein, A.D.
,
COHORTS Group
(2023)
Growth in infancy and childhood and age at menarche in five low- or middle-income countries: Consortium of Health Orientated Research in Transitional Societies (COHORTS).
The Journal of nutrition, 153 (9), .
(doi:10.1016/j.tjnut.2023.07.003).
Abstract
Background: earlier age at menarche is associated with behavioural and noncommunicable disease risks. The influence of birthweight (intrauterine) and postnatal growth on age at menarche is not well studied in low- and middle-income countries (LMIC), OBJECTIVE: Therefore, we investigated these associations in five LMIC birth cohorts.
Methods: we analysed data from Brazil, Guatemala, India, the Philippines, and South Africa (n=3983). We derived stunting (<-2 SDS) at 24mo using the WHO child growth standards. We generated interaction terms with categorised birthweight and conditional weight (lighter<0 or heavier=>0), and height (shorter<0 or taller=>0) z-scores. We categorised early-, modal- and late-onset menarche and used multilevel ordinal regression. We used multilevel linear regression on continuous age at menarche.
Results: mean age at menarche was 12.8y (95% CI: 12.7 - 12.9). Birthweight was not associated with age at menarche. Conditional height at 24mo and mid-childhood (OR 1.35; 95% CI 1.27-1.44 & 1.32; 1.25-1.41, respectively) and conditional weight at 24mo and mid-childhood (OR 1.15; 1.08-1.22 & 1.18; 1.11-1.25, respectively) were associated with increased likelihood of early-onset menarche. Being heavier at birth and taller at 24mo was associated with a 4-month (95% CI 0.8-7.6) earlier age at menarche than being lighter at birth and shorter at 24mo. Being heavier at birth but lighter in mid-childhood was associated with a 3-month (95% CI 0.8-4.8) later age at menarche than being lighter at birth and mid-childhood. Age at menarche was 7mo later in stunted than non-stunted girls.
Conclusion: age at menarche is inversely related to relative weight gain but also to rapid linear growth among those born shorter but remained stunted, and those born taller and grew excessively. These findings do not deter the global health goal to reduce growth faltering but emphasise the potential adverse effects of an obesogenic environment on adolescent development.
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More information
Accepted/In Press date: 6 July 2023
e-pub ahead of print date: 13 July 2023
Published date: September 2023
Additional Information:
Funding Information:
The Wellcome Trust (089257/Z/09/Z) has funded the COHORTS collaboration. The Bill and Melinda Gates Foundation (OPP1020058 and OPP1164115) provided additional funding for data analysis for this paper. Funding for the individual cohorts was as follows: Pelotas Birth Cohort (Brazil): Wellcome Trust; INCAP Nutrition Trial Cohort Study (Guatemala): the US National Institutes of Health; New Delhi Birth Cohort Study (India): Indian Council of Medical Research, US National Center for Health Statistics, British Heart Foundation, Medical Research Council (UK) and the UK Department for International Development (DFID) under the MRC/DFID concordat; Cebu Longitudinal Health and Nutrition Study (the Philippines): US National Institutes of Health; Birth to Twenty (South Africa): Wellcome Trust, South African Medical Research Council and University of the Witwatersrand. S.A.N., L.K.M., and L.M.R. are supported by the DST-NRF Centre of Excellence in Human Development at the University of the Witwatersrand, Johannesburg, South Africa.
Keywords:
age at menarche, birth cohort, infant, linear growth, low- and middle-income countries, obesity, weight gain
Identifiers
Local EPrints ID: 479869
URI: http://eprints.soton.ac.uk/id/eprint/479869
ISSN: 0022-3166
PURE UUID: 05ec574c-fd40-4c78-8ecd-d2a5a734fd19
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Date deposited: 27 Jul 2023 16:29
Last modified: 18 Mar 2024 02:41
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Contributors
Author:
L.H. Nyati
Author:
L.K. Micklesfield
Author:
L. Adair
Author:
N. Lee
Author:
R. Martorell
Author:
L.M. Richter
Author:
H.S. Sachdev
Author:
B. Horta
Author:
A.D. Stein
Corporate Author: COHORTS Group
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