A Study Of Age At Menarche, The Secular Trend And Factors Associated With It

摘要

Background: Considering the economic and industrial development of India, the secular trend in age at menarche, observed in European, North American and other countries is likely to exist in Indian girls.Aim : Present study attempts to find the mean age at menarche in girls of Pune city (Maharashtra), study its secular trend and the association of age at menarche with socioeconomic status, diet and exercise.Subjects and methods : Age of menarche of 742 Maharashtrian girls (age 9 to 16 years) was studied.Results and conclusion : Mean menarcheal age was 12.62 +/-1.05 years. The secular trend in the age at menarche was well demonstrated in Maharashtrian urban girls. The mean age of menarche observed in our study possibly indicate the stabilization of the secular trend. The age at menarche is strongly associated with socioeconomic status, but not with type of diet and day-to-day physical activity.Knowledge of the age at menarche will help the government to design and implement programmes about reproductive health of women, to set laws about age at marriage, family planning, abortion etc and to decide the appropriate age at which the topics like the sex education, contraception and sanitary practices can be incorporated in schools. Introduction Menarche occurs earlier than it once did in many parts of the world especially in Europe and North America 1234 . In these regions, it declined at the rate of approximately four months per decade till it stabilized at around 13 years 1567 . This was attributed to better socioeconomic status and improved health & nutrition. This decline is expected in Indian girls considering the economic development of the country in past few decades. As the industrialization and hence the wealth is concentrated more in urban areas than the rural ones, its impact on the girls residing in urban areas is likely to be prompt. Few studies were carried out in Maharashtra earlier to find the age of menarche. However, we are unaware of any such study in the past one decade. Various factors have been postulated to affect the age at menarche like the socioeconomic status, diet, exercise, environment, sibship, religion, genetic and hereditary factors, ethnicity, psychological stress, migration and chronic illnesses with opinions both supporting and rejecting it 8910111213 .The present study attempts to find the age at menarche in girls from Pune city of Maharashtra and study its secular trend, if exists. We also investigated whether the age at menarche is associated with socioeconomic status, diet & exercise. The findings are reported here. Material and Methods Total 748 Maharashtrian school going girls in the age group 9 to 16 years participated in this study. To ensure the data from all socioeconomic strata we selected one convent and one municipal corporation school in Pune city randomly. The data was collected during January to March 2003. The study, its importance and important concepts like age at menarche, per capita income etc were explained to the students and teachers in local language. Informed consent was taken from parents of students willing to participate. A prestructured pretested questionnaire having questions about date of birth, current age in years and months, month and year of menarche, age at menarche, history of any chronic illnesses / major illnesses in the preceding three years, socioeconomic status of parents, dietary habits and exercise was provided to the subjects, all of them returned it answered with the help of parents and teachers (100% response rate). The subjects giving history of major/ chronic illnesses were excluded from the study. The birthdates were confirmed from school records. The mean age at menarche was calculated by probit analysis and the subjects were categorized in three groups viz. those attained early menarche (between 10 & 12 years of age), ideal menarche (between 12 to14 years) and late menarche (between 14 to16 years of age). The Kuppuswamy classification 14 was fol