Early life household intactness and timing of pubertal onset in girls: a prospective cohort study.
Early life household intactness and timing of pubertal onset in girls: a prospective cohort study.
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DOI：
10.1186/s12887-020-02345-w
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发表时间：
2020-10-28
期刊：
影响因子：
2.4
通讯作者：
Kubo A
中科院分区：
文献类型：
--
作者：
Aghaee S;Deardorff J;Greenspan LC;Quesenberry CP Jr;Kushi LH;Kubo A
经历过早年家庭压力的女孩可能会增加青春期提前的风险，这对青少年和成人健康产生不利影响。我们使用来自北方加州的不同种族/民族的女孩队列评估了家庭完整性和青春期开始之间的关联。一项对2003 - 10年出生的26,044名女孩的前瞻性队列研究。从出生到6岁与父母共同生活的女孩被认为来自"完整"家庭，而其他女孩则属于"非完整"家庭。青春期发育采用儿科医生评估的乳房和阴毛坦纳分期进行测量。青春期开始定义为乳房（乳房初长）和阴毛（阴毛初长）从坦纳1期过渡到2+期。月经初潮数据收集从常规的健康儿童问卷调查。采用Weibull回归模型进行左、右和间隔删失，以确定乳房和阴毛早发的风险，采用Logistic回归评估初潮早发（年龄<12岁）的风险。与来自完整家庭的女孩相比，在2岁之前暴露于非完整家庭的女孩发生乳房早长和阴毛早长的风险增加，种族/民族的影响显著。黑人女孩中的相关性最强（乳房初长和阴阜初长的校正风险比[HR]：1.60，95%置信区间[CI]：1.29，1.98; HR：1.42，95%CI：1.15，1.77）。亚洲/太平洋岛民之间没有显著的联系。2岁之前生活在非完整家庭的女孩也有更早月经初潮的风险，但没有种族/民族的相互作用。调整青春期前肥胖并没有改变这些关联。2岁后生活在非完整家庭与青春期提前之间的关联较弱，但仍然很重要。在生命早期暴露于一个不完整的家庭可能会增加女孩早熟的风险。未来的心理社会干预措施侧重于提高家庭凝聚力，并努力减少不完整家庭的儿童压力，可能会减轻这些负面影响，从而防止青春期提前和健康差距的未来不利健康影响。
Girls who experience early-life familial stress may have heightened risk of early puberty, which has adverse implications for adolescent and adult health. We assessed the association between household intactness and pubertal onset using a racially/ethnically diverse cohort of girls from Northern California. A prospective cohort study of 26,044 girls born in 2003-10. Girls living with both parents from birth up to 6 years were considered to come from “intact” households while others constituted “non-intact” households. Pubertal development was measured using pediatrician-assessed Tanner staging for breast and pubic hair. Pubertal onset was defined as the transition from Tanner Stage 1 to 2+ for breast (thelarche) and pubic hair (pubarche). Menarche data was collected from routine well-child questionnaires. Weibull regression models accommodating left, right, and interval censoring were used to determine risk of earlier thelarche and pubarche, and logistic regressions were used to assess the risk of early menarche (age < 12). Girls exposed to non-intact households before age 2 years were at increased risk for earlier thelarche and pubarche with significant effect modification by race/ethnicity, compared with girls from intact households. The associations were strongest among Black girls (adjusted hazard ratio [HR]: 1.60, 95% confidence interval [CI]: 1.29,1.98; HR: 1.42, 95%CI: 1.15,1.77 for thelarche and pubarche, respectively). There were no significant associations among Asian/Pacific Islanders. Girls who lived in non-intact households before age 2 years were also at increased risk for earlier menarche, but without race/ethnic interaction. Adjustment for prepubertal obesity did not change these associations. Associations between living in non-intact households after age 2 years and early puberty were weaker but still significant. Exposure to a non-intact household early in life may increase the risk of early puberty in girls. Future psychosocial interventions focused on improving family cohesiveness and efforts to reduce childhood stress among families that are non-intact may mitigate these negative associations, thereby preventing future adverse health effects of early puberty and health disparities.
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