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)

• 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
• Journal Title: The Journal of Nutrition
• Volume: Volume 153, Number 9
• Publisher: Elsevier | 2023-07-13, Pages 2736-2743
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1016/j.tjnut.2023.07.003
• Subjects: Health Sciences, General
• Keywords: infant; linear growth; weight gain; obesity; age at menarche; birth cohort; low- and middle-income countries

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.