Girls Ages Research Articles

Social norms and maternal health information-seeking behavior among adolescent girls: A qualitative study in a slum of Bangladesh.

Adolescent girls of reproductive age who actively seek information on maternal health often tend to have better health-seeking behaviors and maternal health outcomes. Due to scant research on reproductive aged adolescent girls' maternal health information seeking behavior in slum, in connection with social norms, we aimed for this particular study. Adopting an explorative qualitative research approach, we collected data from purposively selected married and unmarried adolescent girls aged 15-19 of different occupation by implying 12 in-depth interviews (IDIs), 2 focus group discussions (FGDs) with the same categories employed for IDIs, and 2 key informant interviews (KIIs) with a traditional birth attendant and a drug seller. Furthermore, the data were subjected to thematic analysis. Care's Social Norms Analysis Plot (SNAP) framework was undertaken as an interpretative tool for data that was emerging rather than serving as the foundation for the study's conduct and design. Thematic analysis was followed to analyze primary data. Findings show that most girls rely on maternal health-related information from unverified sources, including family members, traditional birth attendants, and drug sellers, which increases health risks. The majority reported that adolescent girls need professional healthcare providers in their area who would work according to their work schedule as most of the girls are engaged in income-generating work for about 9-11 hours, and the scope of work (daily wagers) hardly supports 'leave with pay'. Therefore, there is a critical need for professional healthcare services tailored to the girls' work schedules. Social norms and stigma further restrict access to reliable health information, especially for unmarried girls. Socioeconomic disparities also shape health-seeking behaviors, with wealthier adolescents having greater access to formal healthcare services. Addressing these barriers is crucial for improving maternal health outcomes. The results might be useful for informed policy formulation and program design to ensure better health outcomes for marginalized adolescents.

Black Girls' Emotional Regulation: Investigating the Roles of Parent and Peer Relationships and Neighborhood Safety.

The current study investigates the role of parent and peer relationships and neighborhood safety on Black adolescent girls' emotional regulation (ER). Guided by an intersectional ecodevelopmental framework, the data derived from 188 youth punishment system-involved girls ages 12 to 17 in a short-term detention facility. Data from the 2014 Imara study-a randomized control trial of a sexual reproductive health intervention-was analyzed using multivariate path analysis. Imara comprises a local convenience sample of Black girls in a southern US short-term detention facility. Path analysis results noted the impact of social domain variables: parents, peers, and neighborhood safety on ER, revealing primarily negative direct and indirect effects. However, of note were nuanced findings, which showed that having negative peers was indirectly and positively associated with girls' ER. It was also noted that there was a negative relationship between negative peers and neighborhood safety. This study has implications for intervention programs that should be tailored and culturally responsive. Detention, legal system, and other professionals should consider the unique circumstances and coping mechanisms of Blackgirls and designing interventions that reflect their lived experiences and unique social environments.

Early Exposure to Deprivation or Threat Moderates Expected Associations Between Neural Structure and Age in Adolescent Girls.

Childhood adversity (CA) is associated with increased risk of negative health outcomes. Research implicates brain structure following CA as a key mechanism of this risk, and recent models suggest different forms of adversity differentially impact neural structure as a function of development (accelerated or attenuated development). Employing the Dimensional Model of Adversity and Psychopathology, we examined whether deprivation and threat differentially impact age-related change in cortical thickness, cortical surface area, and subcortical structure volume, using whole-brain and region of interest analyses (N = 135). In youth without CA, age predicted less surface area across adolescence, consistent with normative data. However, for adolescents with more deprivation exposure, as age increased there was attenuated surface area decreases in the orbitofrontal and superior-parietal cortex, regions recruited for higher-order cognition. Further, for those with more threat exposure, as age increased surface area increased in the inferior-temporal and parietal cortex, regions recruited in socio-emotional tasks. These novel findings extend work examining the impact of dimensions of adversity at a single-age and broaden current conceptualizations of how adversity might impact developmental timing.

Prevalence of diseases of digestive organs in children in the Udmurt Republic

Introduction. Conducting targeted epidemiological studies allows objectively characterizing the health status of the population. Purpose of the work is to characterize current trends in the epidemiology of digestive diseases in children in the Udmurt Republic based on a special study. Materials and methods. Survey of 2516 children of age 6–17 years: 6–14 years — 1,482, 15–17 years adolescents — 1,034. The study was continuous, all students of two secondary schools in Izhevsk. Stages: survey of schoolchildren (n = 2,516) and parents; clinical examination (n = 2,516); laboratory and instrumental examination in children suspected of having pathology of the digestive organs based on the results of stages I and II; IV — summing up and forming a group of children with proven pathology of the digestive organs (n = 1,141). Assessment of the reliability of differences in indicators based on Student’s t-test. Results. The prevalence of gastroenterological diseases among all children does not have a gender component (p = 0.1). In the younger age group, girls and boys get sick with the same incidence. In adolescents, the prevalence of gastroenterological pathology in girls is higher than in boys (p < 0.001). The prevalence among boys of different ages does not have a statistical difference, and among girls of different ages, older schoolgirls are more often affected (p < 0.001). In the structure of pathology of the digestive organs in 6-17 years children dominated due to diseases of the stomach and duodenum. The prevalence of diseases of the hepato-pancreatic-biliary system and intestines was the same. The prevalence of digestive diseases is 453.5 ± 9.9 per 1000 subjects. The proportion of functional diseases is 9.9–96.7%, depending on age and the affected area of ​​the gastrointestinal tract. Conclusion. The true prevalence of digestive diseases exceeds official statistics. The structure is dominated by diseases of the gastroduodenal zone. Epidemiological features include an increase in the prevalence of pathology in girls of puberty. In children aged 6–14 years, functional diseases predominate; in children aged 15–17 years, the proportion of organic diseases increases.

The method of determining abdominal obesity by waist circumference in Ukrainian children

Background. The prevalence of obesity in children has a trend of constant growth. A third of the pediatric population suffers from excess body weight and obesity, which are associated with such pathological conditions as hypertension, insulin resistance, hyperglycemia, type 2 diabetes, dyslipidemia, metabolic syndrome (MS) and early cardiovascular dysfunction. Waist circumference (WC) measurement is a simple noninvasive screening tool to identify children with abdominal obesity, MS, and increased cardiovascular risk. The purpose of the study was to develop age- and gender-specific WC percentiles for Ukrainian children aged 10–17 years and to determine possible WC cut-offs for detecting abdominal obesity. Materials and methods. 1566 children aged 10–17 were examined, 759 boys and 807 girls. According to the WHO protocol, WC was measured using a flexible centimeter tape in a standing position midway between the lower rib and the upper front edge of the ilium. The threshold point for detecting abdominal obesity was WC ≥ 90th percentile of the distribution according to age and sex (IDF Consensus, 2007). Results. Age and gender percentiles of WC and cut-off at the level of the 90th percentile in Ukrainian children and adolescents are presented. The importance of gender assessment of WC lies in the reliable difference of indicators in children aged 10–12 and 15–17 years and growth of parameters with age in both boys and girls. The need for age assessment of WC is due to increasing the 90th percentile indicators in girls aged 10–17 from 76 to 90.5 cm and in boys from 75.9 to 94 cm. The data obtained can serve as a source for screening and identifying children with abdominal obesity, increased metabolic risk and a better understanding of current trends in childhood obesity. It has been suggested that new WC reference values should be added to clinical examinations to help pediatricians and family physicians reduce cardiovascular risk in children. Conclusions. In the diagnosis of MS in children, it is recommended to use the proposed specific percentiles of WC for sex and age, the values of which ≥ 90th percentile of the distribution should be utilized for detection of abdominal obesity and further diagnosis of MS. Measuring and evaluating WC in routine pediatric examinations is important.

Breastfeeding and Children's Cognitive Development up to the Age of 4 Years: The Japan Environment and Children's Study.

Objective: Breastfeeding, depending on its duration, has been suggested to benefit children's cognitive development. We aimed to examine this issue by using the Japan Environment and Children's Study, a nationwide prospective birth cohort study. Methods: We evaluated the relationship between feeding methods and cognitive development in 2- and 4-year-old children. We classified the children based on the following feeding method during the first 6 months postpartum: (1) exclusive breastfeeding group, solely breastfeeding; (2) partial breastfeeding group, solely breastfeeding for ≤5 months and combination of breastfeeding/formula for the rest of months; (3) formula-fed group, solely formula feeding for ≥4 months; and (4) others. Cognitive development was assessed by trained testers using the Kyoto Scale of Psychological Development 2001. Results: Data on 1,329 boys and 1,398 girls were analyzed. Multiple regression analysis was performed using the exclusive breastfeeding group as the reference. Boys of age 2 years in the formula-fed group had significantly lower developmental quotients (DQs) in the language-social developmental (L-S) area (partial regression coefficient [B]: -4.624, p = 0.01), whereas no significant difference was observed in those of age 4 years. Girls of age 2 and 4 years in the formula-fed group had significantly lower L-S area DQ (B: -3.637, p = 0.03 and B: -3.414, p = 0.03, respectively). In the partial breastfeeding group, no significant differences in the L-S area DQ were observed in 2- and 4-year-old boys and girls. Conclusions: Exclusive breastfeeding for the first 6 months postpartum may be more beneficial for verbal cognitive development in 4-year-old girls than solely formula feeding for ≥4 months. Furthermore, breastfeeding combined with formula for the first 6 months postpartum may not have a disadvantage on cognitive development in boys and girls of age ≥ 2 years, when compared with that observed with exclusive breastfeeding during the first 6 months postpartum.

Understanding Behavioral Drivers of Iron and Folic Acid Supplementation and Vitamin A- and Iron-Rich Food Consumption among Women and Adolescent Girls in Niger.

This study examined drivers and barriers to iron and folic acid (IFA) supplementation and consumption of iron- and vitamin A-rich foods among women of reproductive age (WRA) and adolescent girls in Niger. This was an exploratory qualitative study using focus group discussions and semi-structured interviews. This study was conducted in the rural areas of three districts in Maradi and Zinder regions of southern Niger. The study included a purposive sample of 56 WRA (15-49 years), 34 non-pregnant adolescent girls (10-14 years), 105 family members and community leaders, 32 health workers, and 12 national and regional level stakeholders. Respondents demonstrated widespread knowledge of recommendations for IFA during pregnancy and had positive attitudes toward supplements. However, supply barriers were significant, and adherence was limited by side effects, among other constraints. Despite knowledge about and positive attitudes towards micronutrient source foods, respondents reported that limited food access was an overriding constraint to increasing consumption. WRA were seen as nutritionally vulnerable, however husbands were often not able to provide sufficient nutritious food and there was a cultural expectation that wives serve themselves food last. Adolescent girls were not seen as nutritionally vulnerable and there was little family support for their consumption of nutritious foods. Projects should work with local actors to develop multi-pronged solutions that address supply and access barriers for IFA and micronutrient-rich foods and to improve social support for nutrition.

Determinants of malnutrition among adolescent females of age 15–19 years in an urban slum of Raipur city

ABSTRACT Context: Adolescent girls suffer the brunt of malnutrition due to increased nutritional needs to facilitate rapid growth spurt including menstruation and increased physical activity. This vulnerable group has low social power and is subjected to peer and social pressures related to body image and weight. All these factors along with the sociocultural milieu may lead to a spectrum of nutritional problems in them. Aims: To determine factors associated with malnourishment among adolescent females of age 15–19 years in an urban slum of Raipur City. Settings and Design: The study setting was the urban field practice area of the institute in Raipur. The study was an analytical cross-sectional study done from January 2022 to June 2023 among 401 adolescent girls of age 15–19 years. Methods and Material: The sampling was done using the consecutive sampling method. The study tools used were a semi-structured questionnaire on sociodemographic variables and details of the respondents, anthropometric measurements, dietary assessment using the 24-hour food recall method, and food consumption patterns using a food frequency questionnaire. Statistical Analysis Used: The Chi-square test of significance was applied to find the association between malnourishment with the input variables. For calculating the strength of the association, the odds ratio was estimated for those variables with P value < 0.2 in the Chi-square test, and later the odds ratio was adjusted for confounding with the same variables, using multivariable logistic regression. Results: According to BMI-for-age Z scores, 2% were severely thin (< −3 SD), 9.7% were thin (−3 to − 2 SD), 5% were overweight (1 to 2 SD), and 1.5% were obese (>2SD). While measuring the height-for-age Z scores, 5.5% had severe stunting and 21.9% had moderate stunting. Those respondents with educational status of high school or below [AOR 3.5 (1.8–6.8), P < 0.001] and those who did not consume a non-vegetarian diet [AOR 2.1 (1.1–4.1), P = 0.02] had significantly higher adjusted odds of being undernourished (severely thin or thin) as compared to those with educational status above high school and those who consumed a mixed diet, respectively. The respondents who are currently not going to school/college had significantly higher adjusted odds [AOR 2.2 (1.2–3.8), P = 0.007] of being stunted when compared to those who are attending school/college. Conclusions: The significant levels of malnutrition observed in this study among late adolescent girls aged 15–19 years—11.7% undernourishment, 6.5% overnourishment, and 27.4% stunting—highlight the concerning vulnerability of this population. The higher prevalence of stunting throws light onto the chronicity of malnutrition. As seen from the significant associations, proper education, and a mixed diet will help nurture a healthy female adolescent population.

Specific features of cytokine synthesis in adolescent girls with oligomenorrhea and low body mass index

The article is devoted to the study of the cytokine component of immunity in teenage girls with oligomenorrhea, underweight and with normal body weight in comparison with teenage girls with a normal menstrual cycle and normal body weight, which is of great importance to pediatric gynecology. Studying of the cytokine profile in oligomenorrhea will allow early identification of the development of many gynecological pathologies, including polycystic ovary syndrome, endometrioid neoplasms, as well as for understanding the pathogenesis of these conditions and developing approaches to their diagnosis and treatment, which is of great practical importance. The authors conducted an immunological study of teenage girls with oligomenorrhea with underweight and normal body weight in comparison with teenage girls with a normal menstrual cycle and normal body weight. Purpose of the study: to study the levels of IL-6, IL-17A, IL-18 and IL-10 in adolescent girls with oligomenorrhea and underweight. Teenage girls (N = 52) aged 13 to 17 years with established menstrual irregularities were examined. The control group consisted of 24 practically healthy girls of the same age. From the study, it was established that girls with oligomenorrhea and underweight have a pronounced increased synthesis of proinflammatory cytokines IL-6, IL-17A and IL-18. In the same group of girls, an increase in the level of the anti-inflammatory cytokine IL-10 was detected, which may be an attempt by the body to compensate for inflammatory processes. However, IL-10 levels remain elevated, which may indicate an immune imbalance. The discovered imbalance in the cytokine profile emphasizes the complexity of the pathogenesis of oligomenorrhea in girls with underweight, and the identified levels of the studied cytokines can serve as biomarkers that will help in diagnosis, assessment of severity, and prediction of the course of the disease state.

Three Therapy Regimens and Their Cost-effectiveness for Girls With Central Precocious Puberty: A Real-World Clinical Study.

The objective of this study was to evaluate the effectiveness and cost-effectiveness of different therapy regimens for girls with central precocious puberty (CPP). This study retrospectively analyzed CPP girls from 2013 to 2021 and grouped them into GnRHa, Mixed, and GnRHa+GH based on therapy regimen. While comparing the differences among these groups, initial age and bone age of GnRHa group girls were significantly lower than Mixed and GnRHa+GH groups, but their growth level was significantly higher (P < .05). In the Mixed group, starting with GnRHa alone, the predicted adult height improvement (ΔPAH) decreased to -1.0 cm in the second year, prompting addition of growth hormone (GH) therapy in the third year, resulting in a ΔPAH increase to 3.0 cm. At therapy completion, final predicted adult heights (PAHs) were similar among the groups at 155.6 to 156.7 cm, with ΔPAH between 5.8 and 6.5 cm and no significant intergroup differences (P > .05). Younger CPP girls with greater height can begin therapy with GnRHa alone. Consideration of combining GH therapy depends on growth velocity and PAH during treatment.

Формирование логического мышления у старших дошкольников с тяжелыми нарушениями речи на основе информационной теории развития психики Л.М. Веккера

&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Objectives. &lt;/strong&gt;Contemporary methods of development of logical thinking in preschool children with severe speech disorders (SSD) help to smooth out problems of academic failure at school and social disadaptation. A program for the development of verbal and logical thinking in senior preschool children with SSD was tested. The program was based on the information theory of mental development by L.M. Vekker.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Methods.&amp;nbsp;&lt;/strong&gt;The implementation of the experimental program for the development of logical thinking included the creation of psychological and pedagogical conditions: modeling of surrounding relationships and processes; consistent introduction of models of different levels of concretization of the abstraction; creation of problem situations between surrounding objects and phenomena. The study involved children with a diagnosis of SSD (7 boys, 2 girls) aged 6 to 7 years (M = 6.5), attending a preschool educational organization. To identify &amp;ldquo;deficits&amp;rdquo; of verbal-logical thinking in children with speech disorders, a group of children without speech disorders (4 boys, 5 girls) of the same age (M=6.5) was used. Two measurements were taken &amp;mdash; before and after the implementation of the formative program. To diagnose the parameters of verbal logical thinking, the &amp;ldquo;Methodology for studying the level of children&amp;rsquo;s readiness for school&amp;rdquo; by L.A. Yasyukova was used.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Results&lt;/strong&gt;. Comparison of the indicators of the level of development of thinking in children with speech disorders with the results of children without speech disorders at the first stage of the study showed differences (p&amp;le;0.01) in the following parameters: speech and visual classifications, abstract thinking. At the second &amp;mdash; developmental &amp;mdash; stage, a positive shift at a reliable statistical level occurred in the parameters of the methodology: speech analysis-synthesis (p&amp;le;0.05), selection of antonyms (p&amp;le;0.05), speech analogies (p&amp;le;0.01), speech classifications (p&amp;le;0.01), visual analysis synthesis (p&amp;le;0.01), visual classifications (p&amp;le;0.01).&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;. The results of the study showed that children with speech disorders have learned to use symbolic and speech models to understand logical relationships at the level of visual-effective and visual-figurative thinking. According to the indicator visual analysis-synthesis, children with speech disorders demonstrated results even higher than children without speech disorders. Work is planned to further replenish the children&amp;rsquo;s vocabulary, to include in the program a set of training in different types of judgments and conclusions.&lt;/p&gt;

Time trends in adolescent depressive symptoms from 2010 to 2019 in Norway: real increase or artifacts of measurements?

Whether the recent rise in adolescent self-reported depressive symptoms is influenced by changing reporting behavior is much debated. Most studies use observed sum scores to document trends but fail to assess whether their measures are invariant across time, a prerequisite for meaningful inferences about change. We examined whether measurement noninvariance, indicative of changing perceptions and reporting of symptoms, may influence the assessment of time trends in adolescent depressive symptoms. Data stem from the nationwide repeated cross-sectional Ungdata-surveys (2010-2019) of 560 712 responses from adolescents aged 13 to 19 years. Depressive symptoms were measured with the Kandel and Davies' six-item Depressive Mood Inventory. Using structural equation modeling, we examined measurement invariance across time, gender and age, and estimated the consequences of noninvariance on cross-cohort time trends. Across most conditions, the instrument was found measurement invariant across time. The few noninvariant parameters detected had negligible impact on trend estimates. From 2014, latent mean depressive symptom scores increased among girls. For boys, a U shaped pattern was detected, whereby an initial decrease in symptoms was followed by an increase from 2016. Larger issues of noninvariance were found across age in girls and between genders. From a measurement perspective, the notion that changed reporting of symptoms has been an important driver of secular trends in depressive symptoms was not supported. Thus, other causes of these trends should be considered. However, noninvariance across age (in girls) and gender highlights that depressive symptoms are not necessarily perceived equivalently from early to late adolescence and across gender.

Central Precocious Puberty During the COVID-19 Pandemic Period: A Systematic Review of Literature.

Central precocious puberty (CPP) is a condition where the hypothalamus-pituitary-gonadal axis is activated earlier than normal, leading to premature development of secondary sexual characteristics before eight years of age in girls and nine years of age in boys. The purpose of this study was to critically and systematically evaluate the literature regarding CPP rise during the COVID-19 pandemic. We searched PubMed and Google Scholar for relevant articles using the following MeSH terms: "COVID-19, "precocious puberty," "early puberty," "pediatric endocrinology," and "pandemic effects." We included studies calculating the risk of CPP before and during the COVID-19 pandemic. We excluded studies looking at patients with an identifiable cause for CPP or with peripheral precocious puberty. The primary outcome was the prevalence of central precocious puberty during the pandemic compared to the pre-pandemic period. We analyzed data regarding anthropometric, biochemical, and pelvic ultrasound data between the two groups. Overall, 16 studies with 2.175 subjects were included, of which 1.818 were diagnosed with CPP. There was a rise in the number of new diagnoses of CPP during the COVID-19 pandemic (985 subjects) compared with the pre-pandemic period (833 subjects). The mean age of diagnosis in the first group was 7.42 years versus 7.54 years in the second group. Notably, CPPduring the pandemic was associated with a higher body mass index (BMI) compared with the group of the pre-pandemic period (17.50 versus 17.08). The pandemic and lockdowns led to changes in lifestyle habits, social isolation, sleep disturbance, excess screen time, and increased stress levels. We hypothesize that these alterations influenced the increase in CPP frequency.

7795 Gender based differences in peripubertal growth patterns may offer insight into the twofold representation of boys compared to girls among children referred for growth hormone stimulation tests

Abstract Disclosure: Y. Dekel: None. L. Horowitz : None. R. Gendelman: None. M. Cohen: None. Background: Growth hormone (GH) stimulation tests are essential in the diagnostic assessment of pediatric GH deficiency (GHD). However, the tests bare multiple limitations, resulting from both intrinsic and child-related factors. Thus, referral decisions are key in making a correct diagnosis. Several studies demonstrated a gender bias in referral for short stature evaluation with a higher proportion of boys referred and diagnosed with GHD. Moreover, the boys had higher height z-scores upon referral. About 100 GH stimulation-tests are conducted annually at our pediatric endocrinology unit. We aimed to characterize the children that underwent GH stimulation-testing between 2017-2021, specifically focusing on differences based on: 1) gender 2) GH secretion status (deficient vs. sufficient). Methods: A retrospective review of charts of children aged 0-18 years that performed GH stimulation-tests at the Rambam pediatric endocrinology unit between the years 2017-2021 was conducted. Children followed at an outside clinic that had a first GH stimulation-test elsewhere, were excluded. Data was collected through the electronic database and by manually screening medical charts. The IBM SPSS statistics package 21 version was used for analysis. Results: Four-hundred children were included in the study, 266 boys (66.5%) and 134 girls (33.5%). Mean age 8.8±4.2 years, mean height z-score -2.3±0.7 and mean mid-parental height standard-deviation-scores (MPH-SDS) -0.6±0.7. The mean difference between MPH-SDS and child height-z-score was 1.7±0.8 SDS. Mean age was younger in girls compared with boys, 7.3±3.3 and 9.6±4.4 years respectively (p&amp;lt;0.001). Age distribution differed between genders, while refferals peaked between 3-4 years of age in both girls and boys, a second peak at 13-14 years of age was evident only in boys. Interestingly, there was no significant difference between boys and girls in height z-score, difference from MPH-SDS or rates of GHD. Overall, 93 (23.3%) children were diagnosed with GHD, 32 girls (24%) and 61 boys (23%). Children with GHD were younger and had higher BMI-SDSs compared to GH sufficient children, age 7.8±3.8, 9.2±4.3 years respectively (p=0.003), BMI z-score 0.17±1.38, -0.47±1.15 respectively (p&amp;lt;0.001). Conclusion: Twice as many boys than girls were referred for GH stimulation tests in our cohort. Based on differences in age distribution, the peripubertal physiologic growth deceleration that occurs later in boys, likely contributes to this finding. This male-to-female ratio is similar to ratios reported in the literature regarding short stature referrals; however, in contrast to the literature, in our cohort it could not be explained by an anthropometric bias in referral criteria. Presentation: 6/3/2024

Trajectories of personal agency by gender and pubertal development among adolescents in Kinshasa: Longitudinal evidence from the GlobalEarly Adolescent Study

BackgroundEmpowerment research has largely focused on adult women with little focus on younger adolescents. Additionally, despite recognition that empowerment is a process, few studies have longitudinally explored its development. MethodsWe used secondary data from four waves of the Global Early Adolescent Study to explore trajectories in the development of three domains of agency (i.e. the internal processes composing empowerment) - Freedom of Movement, Voice, and Decision-Making - for 1188 boys and 1153 girls in Kinshasa, Democratic Republic of Congo. Respondents were age 10–14 at enrollment and followed through age 14–18. We created scales for each domain and conducted gender- and age-stratified latent growth curve modeling with random effects, comparing age 10–14 to age 15–18, accounting for clustering within individuals over waves. We examined the role of puberty within each domain in the analysis of age 10–14. ResultsScores across all domains increased with age for boys and girls, with the exception of Voice amongst boys 10–14. Rates of change varied by age group and gender; for boys, scores increased at a faster rate for older boys relative to younger boys for Freedom of Movement (ß(10-14): 3.98 versus ß(15-18): 6.12) and Voice (ß(10-14): .50 versus ß(15-18): 2.54). Relative to younger girls, scores amongst older girls increased at a faster rate for Freedom of Movement (ß(10-14): 1.76 versus ß(15-18): 3.72) and a slower rate for Decision-Making (ß(10-14): 6.41 versus ß(15-18): 2.80). Puberty was associated with significant increases in scores across all domains for both genders, with the exception of Decision-Making for girls. InterpretationYoung people develop/acquire different forms of agency at different stages of adolescence and development is not uniform across forms. Gender inequalities in agency amplify at puberty, signaling the need to intervene at or before this critical stage of development.

7892 Longitudinal Changes in Bone Microarchitecture and Strength in Girls with Type 1 Diabetes

Abstract Disclosure: R. Dhaliwal: None. R.K. Saunders: None. M. Misra: None. M.L. Bouxsein: None. D.M. Mitchell: None. Introduction: Type 1 diabetes (T1D) confers an increased fracture risk, only partly explained by low areal bone mineral density (aBMD). We have previously shown in a cross-sectional study that bone microarchitecture is altered early in the course of T1D. The goal of this study is to evaluate how T1D influences longitudinal changes in volumetric BMD (vBMD) and microarchitecture. Methods: This is a 2-year prospective study of girls ages 10-16 years (62 with T1D and 59 controls). We used dual-energy x-ray absorptiometry (DXA) to measure aBMD, and high-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius (7% site) and tibia (8% site) to measure vBMD and microarchitecture. We used linear mixed models to assess the effects of T1D on change in bone parameters over time, adjusting for bone age as an index of skeletal maturity, height, lean mass index (LMI), and fat mass index (FMI). Results: At baseline, mean duration of disease in T1D was 4.8 ± 3.2 years, and mean HbA1c was 8.6 ± 1.4%. The groups did not differ by age, bone age, and height, while T1D participants had higher LMI (p&amp;lt;0.001) and borderline higher FMI (p=0.107). Linear growth, weight gain, and changes in body composition over time did not differ between groups. Growth-mediated aBMD gains were observed in both groups at the subtotal body, total hip, femoral neck, and spine. While adjusted aBMD as well as trabecular bone score were lower in T1D, we did not observe between-group differences in changes in these endpoints over time. In both groups, at the distal radius, we observed significant increases over time in total and cortical vBMD, cortical thickness, trabecular (Tb) thickness, and estimated failure load, while cortical porosity decreased. While several microarchitectural parameters were altered in T1D participants, we did not observe significant between-group differences in changes in these measures over time. Of note, trabecular development was subtly altered, with T1D participants demonstrating a borderline significant decrease in Tb vBMD (-14.3 ± 9.0 mg HA/cm3, p=0.112) and Tb number (-0.14 ± 0.07 mm-[1], p=0.057), while control participants had no change in Tb vBMD or number, but a significant increase in Tb thickness (5.8 ± 2.5 µm, p=0.018). At the distal tibia, we observed similar overall detrimental effects of T1D at baseline. However, we did not observe between-group differences in microarchitectural change over time. Glycemic control as measured by HbA1c was not associated with changes in skeletal parameters among T1D participants. Conclusions: T1D leads to substantially altered areal and volumetric BMD as well as microarchitectural parameters in girls. While our data suggest that much of this deficit appears to occur early in the course of disease as prospective change is similar in T1D and controls, subtle changes in trabecular bone development at the radius may indicate ongoing impairment of bone accrual. Presentation: 6/3/2024

Impaired head circumference growth and behavioural problems in childhood: Longitudinal findings from the MINA-Brazil birth cohort.

Previous evidence on the relation between early head circumference (HC) growth and behavioural outcomes in preschoolers has been inconsistent. We aimed to investigate whether HC growth from birth to 5 years of age was related to internalising or externalising behavioural problems at 5 years of age in a sex-specific manner. Among 303 girls and 318 boys from the MINA-Brazil birth cohort, we examined the associations between changes in HC from birth to 5 years of age and internalising and externalising behaviour problem scores at 5 years according to the Strengths and Difficulties Questionnaire for parents. HC values were transformed into sex- and age-specific z-scores (HCZ) using World Health Organisation standards, and the differences between values at 5 years of age and birth were classified into quintiles. We estimated adjusted mean differences with 95% confidence intervals in behavioural problem scores between HCZ change quintiles using multivariable linear regression by sex. To examine nonlinear associations, we included cubic spline terms. Head circumference growth from birth to 5 years of age was inversely and nonlinearly associated with internalising problems in girls. Compared with girls at the lowest quintile of HC growth, those above had an adjusted 1.27 (95% confidence interval 0.28, 2.27) points lower mean internalising problems score. This association was mostly driven by HC growth during the first 2 years. We found no association between HC growth and externalising behaviour in either sex. Impaired HC growth was related to higher mean internalising problem scores at 5 years of age in girls but not in boys. HC growth was not associated with externalising problems.

Burden and awareness of anemia among adolescent girls of residential school in Telangana.

Adolescence is an important transition phase and the burden of anemia among adolescent school-going children is not well explored. The present study was carried out to determine the prevalence of anemia among school-going adolescent girls and to explore their awareness on anemia. A cross-sectional study was conducted among 217 adolescent girls studying in a residential school of Bibinagar village, Telangana. A pre-tested, semi-structured questionnaire was administered to collect the data. Hemoglobin (Hb) was estimated using TrueHb. Data was entered into excel and was analyzed using SPSS software version 21. The mean (±SD) age of the adolescent girls was 13.8 (±0.99) years. About 74.2 % of the girls were in 12-14 years' age group. About 91.7 % had attained menarche. The prevalence of anemia was 81.6 % with a mean (±SD) Hb of 9.5 (±2.7) g/dl among adolescent girls. Among the adolescent girls, 32.7 % had severe anemia, 31.8 % had moderate anemia and 17.1 % had mild anemia. About 86.2 % adolescent girls had heard of anemia while 60.8 % adolescent girls felt that anemia is preventable and only 27.6 % were aware about iron-rich foods. About 38 % of adolescent girls were not aware of any causes of anemia. The prevalence of anemia was very high among the school-going adolescent girls of rural Telangana. The awareness regarding causes of anemia and iron-rich foods was low among study adolescent girls. Thus, there is a dire need to conduct frequent Test, Treat and Talk (T3) Anemia camps in schools through district school health program.

Association between Changes in Menarcheal Age and Adolescent Idiopathic Scoliosis: An Analysis of 38,879 Patients over 20 Years.

Menarche has a significant impact on the progression of adolescent idiopathic scoliosis (AIS); however, studies in this area are insufficient. This study used large-scale school screening data to investigate the relationship between menarcheal age and AIS, especially the severity of scoliosis. Of 2,326,577 students who participated in school screening for scoliosis (SSS) in South Korea from 2001 to 2021, 38,879 girls with AIS, who experienced menarche, were included. Data including the patient's demographics, such as menarcheal age, Cobb angle, Risser stage, and the interval between menarche and the time of screening were retrieved from the SSS database. Pearson correlation coefficient was used to identify the changes in menarcheal age according to the birth year and to investigate the relationship between menarcheal age and each variable of interest. Based on the birth year, the mean menarcheal ages in girls with AIS from 1988 to 2008 demonstrated a steadily decreasing trend over time (r = -0.857, p < 0.001). Girls with AIS and late menarche demonstrated a higher Cobb angle at the time of screening (r = 0.095, p < 0.001). Other variables did not significantly correlate with menarcheal age. Based on the SSS, a large-scale school screening dataset, menarcheal age in girls with AIS demonstrated an ongoing downward trend in the recent 20 years in South Korea. Notably, girls with AIS and late menarche had a higher Cobb angle at screening. Our findings indicate the need for earlier screening of AIS in girls who have not undergone menarche.

Pattern of physical growth and pubertal changes in adolescent girls with Systemic Lupus Erythematosus.

To study the pattern of physical growth and pubertal changes in adolescent girls with Systemic Lupus Erythematosus (SLE). Weight, height, BMI, waist and hip circumference among 50 adolescent SLE girls (aged 8-17 years) were cross-sectionally studied using standardized techniques and instruments. Breast development stage, presence or absence of pubic and axillary hair and age of attainment of menarche were also noted. With the advancement of age, weight and height of SLE girls increased but they were lighter and shorter compared to normal Indian peers. 18.4% of study girls were short-statured while only one participant was underweight. As per mid-parental height, 34.3% were predicted to have shorter final heights. BMI demonstrated an inconsistent trend with 12.3% and 9.2% being obese and overweight, respectively. Interestingly, 10.7% of SLE girls were at risk of metabolic syndrome (waist circumference >70th centile). About 50% of study girls had attained menarche (mean age: 13.04 ± 1.38 years). Appearance of pubic and axillary hair occurred around 1 year later than attainment of menarche. 33.80% of study subjects were in prepubertal stage of breast development and rest 66.20% were in advanced stages of breast development. SLE girls who had younger age at diagnosis and longer duration of therapy had significant delay in breast development and attainment of menarche. SLE girls show delayed growth and pubertal attainments compared to their normal Indian and Western counterparts. The data presented will provide an understanding of the auxological dynamics and pattern of pubertal changes among adolescent girls with SLE living in north-western India.