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)

• Type of Material: Article
• Authors: Lukhanyo Nyati, University of the Witwatersrand; Shane A. Norris, University of the Witwatersrand; Lisa K. Micklesfield, University of the Witwatersrand; Linda S. Adair, University of North Carolina, Chapel Hill; Caroline Fall, University of Southampton; Nanette R. Lee, University of San Carlos; Reynaldo Martorell, Emory University; Clive Osmond, University of Southampton; Linda M. Richter, University of the Witwatersrand; Harshpal S. Sachdev, Sitaram Bhartia Institute of Science and Research; Bernardo Horta, Universidade Católica de Pelotas; Aryeh D Stein, Emory University
• Language: English
• Date: 2023-07-13
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Author(s)
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.1016%2Fj.tjnut.2023.07.003
• Title of Journal or Parent Work: The Journal of Nutrition
• Volume: 153
• Issue: 9
• Start Page: 2736
• End Page: 2743
• Grant/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: obesity; age at menarche; low- and middle-income countries; infant; linear growth; weight gain; birth cohort
• Research Categories: Health Sciences, General

Abstract

Background Earlier age at menarche is associated with behavioral and noncommunicable disease risks. The influence of birth weight (BW) (intrauterine) and postnatal growth on age at menarche is not well studied in low- and middle-income countries (LMICs). Objective Therefore, we investigated these associations in 5 LMIC birth cohorts. Methods We analyzed data from Brazil, Guatemala, India, the Philippines, and South Africa (n = 3983). We derived stunting (< −2 SD scores) at 24 mo using the WHO child growth standards. We generated interaction terms with categorized BW and conditional weight (lighter < 0 or heavier ≥ 0), and height (shorter < 0 or taller ≥ 0) z-scores. We categorized 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 12.8 y (95% CI: 12.7 12.9). BW was not associated with age at menarche. Conditional height at 24 mo and mid-childhood (OR: 1.35; 95% CI: 1.27, 1.44 and 1.32; 1.25, 1.41, respectively) and conditional weight at 24 mo and mid-childhood (OR: 1.15; 1.08, 1.22 and 1.18; 1.11, 1.25, respectively) were associated with increased likelihood of early-onset menarche. Being heavier at birth and taller at 24 mo was associated with a 4-mo (95% CI: 0.8, 7.6) earlier age at menarche than being lighter at birth and shorter at 24 mo. Being heavier at birth but lighter in mid-childhood was associated with a 3-mo (95% CI: 0.8, 4.8) later age at menarche than being lighter at birth and mid-childhood. Age at menarche was 7 mo later in stunted than nonstunted 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 emphasize the potential adverse effects of an obesogenic environment on adolescent development.