Early menarche and childhood adversities in a nationally representative sample.
Early menarche and childhood adversities in a nationally representative sample.
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DOI：
10.1186/1687-9856-2014-14
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Breslau J
中科院分区：
文献类型：
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作者：
Henrichs KL;McCauley HL;Miller E;Styne DM;Saito N;Breslau J
流行病学证据表明，初潮提前（定义为 11 岁或更早月经开始）在近期出生队列中的患病率有所增加，并且与成年后多种不良的医疗和心理健康结果相关。有证据表明，初潮前发生的童年不幸会导致初潮提前。作为国家合并症调查复制的一部分，对全国代表性 18 岁及以上女性样本 (N = 3288) 进行面对面访谈收集的数据进行了分析。初潮前的童年不幸与 11 岁或更早初潮之间的关联是在离散时间生存模型中估计的，并对访谈时的年龄、种族和体重指数进行了统计调整。调查的逆境包括身体虐待、性虐待、忽视、亲生父亲不在家里、失去其他父母、父母精神疾病、父母药物滥用、父母犯罪、父母间暴力、儿童时期严重身体疾病和家庭经济逆境。月经初潮的平均年龄在十年出生队列中存在差异（χ2₍₄₎ = 21.41，p < .001），范围从最老队列（采访时年龄为59岁或以上）的最高12.9岁到第二年轻队列（28-37岁）的最低12.4岁。童年时期的逆境在年轻人中也比老年人更常见。在 11 种童年不幸中，有 5 种与 11 岁或更早的初潮有关，OR 为 1.3 或更高。这五种逆境中的每一种都与初潮提前的几率增加 26% 有关（OR = 1.26，95% CI 1.14-1.39）。在对同时发生的逆境进行调整后，儿童期性虐待和初潮早期之间的关系仍然存在。 （OR = 1.77，95% CI 1.21-2.6）。这项研究的证据与幼儿家庭环境对内分泌发育的生理影响的假设一致。童年性虐待是与初潮早期最密切相关的逆境。然而，由于童年不幸在家庭中聚集的方式很复杂，因此不能排除高度失调的家庭环境的更普遍影响。
Epidemiological evidence suggests that early menarche, defined as onset of menses at age 11 or earlier, has increased in prevalence in recent birth cohorts and is associated with multiple poor medical and mental health outcomes in adulthood. There is evidence that childhood adversities occurring prior to menarche contribute to early menarche. Data collected in face-to-face interviews with a nationally representative sample of women age 18 and over (N = 3288), as part of the National Comorbidity Survey-Replication, were analyzed. Associations between pre-menarchal childhood adversities and menarche at age 11 or earlier were estimated in discrete time survival models with statistical adjustment for age at interview, ethnicity, and body mass index. Adversities investigated included physical abuse, sexual abuse, neglect, biological father absence from the home, other parent loss, parent mental illness, parent substance abuse, parent criminality, inter-parental violence, serious physical illness in childhood, and family economic adversity. Mean age at menarche varied across decadal birth cohorts (χ2₍₄₎ = 21.41, p < .001) ranging from a high of 12.9 years in the oldest cohort (age 59 or older at the time of interview) to a low of 12.4 in the second youngest cohort (age 28-37). Childhood adversities were also more common in younger than older cohorts. Of the 11 childhood adversities, 5 were associated with menarche at age 11 or earlier, with OR of 1.3 or greater. Each of these five adversities is associated with a 26% increase in the odds of early menarche (OR = 1.26, 95% CI 1.14-1.39). The relationship between childhood sexual abuse and early menarche was sustained after adjustment for co-occurring adversities. (OR = 1.77, 95% CI 1.21-2.6). Evidence from this study is consistent with hypothesized physiological effects of early childhood family environment on endocrine development. Childhood sexual abuse is the adversity most strongly associated with early menarche. However, because of the complex way that childhood adversities cluster within families, the more generalized influence of highly dysfunctional family environments cannot be ruled out.