Factors associated with post-menarcheal growth: results of a longitudinal study in Chilean girls from different socioeconomic statuses

Timing of menarche and pubertal growth patterns using the QEPS growth model

Objectives

To explore the timing of menarche, postmenarcheal growth, and to investigate the impact of various variables on menarcheal age and postmenarcheal and pubertal growth.

Study Design

This longitudinal community population-based study analyzed pubertal growth and menarcheal age in 793 healthy term-born Swedish girls, a subset of the GrowUp1990Gothenburg cohort. The timing of menarche and postmenarcheal growth was related to variables from the Quadratic-Exponential-Pubertal-Stop (QEPS) growth model, birth characteristics, and parental height. Multivariable models were constructed for clinical milestones; at birth, age 7 years, pubertal growth onset, and midpuberty.

Results

Menarche aligned with 71.6% (18.8) of the QEPS model's specific pubertal growth function, at a mean age of 13.0 (1.3) years, ranging from 8.2 to 17.2 years. Postmenarcheal growth averaged 8.0 (4.9) cm, varying widely from 0.2 to 31.1 cm, decreasing with later menarche. Significant factors associated with menarcheal age included height at 7 years, childhood body-mass index, parental height, and QEPS-derived pubertal growth variables. Multivariable models demonstrated increasing explanatory power for each milestone, explaining 1% of the variance in menarcheal age at birth, 8% at age 7 years, 44% at onset of pubertal growth, and 45% at midpuberty.

Conclusions

This study underscores the strong link between pubertal growth and age at menarche. Data available at start of puberty explain 44% of the variation in menarcheal age, apparent on average 3.2 years before menarche. In addition, the study shows a previously seldom noticed wide variation in postmenarcheal height gain from 0.2 to 31.1 cm.

Heavier birth weight associated with taller height but not age at menarche in US women born 1991-1998

OBJECTIVES

Heavier birth weight predicts taller adult height, but it remains unknown the extent to which this additional height increment results from a faster average growth rate versus an extension of the growth period. Aiming to distinguish these effects, this study examined associations between birth weight (BW), age at menarche (an established proxy for growth duration), and near-adult height in a cohort of US young women born in the 1990s.

METHODS

Multiple regression evaluated age-adjusted height as an outcome of BW, age at menarche, indicators of family socioeconomic status, and other potential confounders in a sample of US teens who participated in the National Health and Nutrition Examination Survey between 2007 and 2012 (N = 342). Relevant interactions were also evaluated.

RESULTS

Mean ± SD was 11.9 ± 1.2 years and 3262 ± 592 g for age at menarche and BW, respectively. BW did not predict age at menarche (β = -.01, p = .838). Girls were 1.3 cm taller per year delay in menarche (p < .001) and 2.9 cm taller per 1 kg increase in BW (p < .001). Additionally, the greatest gain in height associated with delayed menarche was observed among the heaviest BW quartile.

CONCLUSIONS

Girls born heavier were taller but experienced menarche at similar ages to girls born lighter. To the extent that age at menarche reflected growth duration, these results demonstrate faster average growth among heavier-born girls. Consistent with fetal programming of average growth rate, these results held after adjustment for confounders of postnatal growth like family socioeconomic status.