Pubic Hair Development Research Articles

Associations of Maternal Gestational Weight Gain and Obesity With the Timing of Pubertal Onset in Daughters.

Early puberty is associated with adverse health outcomes, but little is known regarding early-life determinants influencing pubertal timing. We examined the associations between maternal gestational weight gain (GWG) and the timing of the onset of breast development (thelarche) and pubic hair development (pubarche) in a cohort of 2,070 girls born in a Kaiser Permanente Northern California facility between 2005 and 2006. Using Weibull regression models accommodating interval censoring and adjusting for important confounders, we found that excess GWG was associated with increased risk of early thelarche (hazard ratio (HR) = 1.50, 95% confidence interval (CI): 1.26, 1.78) and early pubarche (HR = 1.35, 95% CI: 1.10, 1.66). Inadequate GWG was associated with early thelarche (HR = 1.36, 95% CI: 1.08, 1.71). The associations between excess or inadequate GWG and risk of earlier thelarche were stronger if mothers were obese before or at the beginning of pregnancy (body mass index ≥30 kg body weight per m height squared) (HR = 2.01, 95% CI: 1.53, 2.63; HR = 2.08, 95% CI: 1.45, 2.98, respectively). Similar associations were found for pubarche outcome. Inclusion of girls' prepubertal body mass index slightly attenuated these associations, but they remained significant. Monitoring of maternal weight before and throughout pregnancy might help prevent early pubertal onset and subsequent negative health outcomes.

The associations between left-hand digit ratio (2D:4D) and puberty characteristics among Chinese girls.

The aim of this study was to analyse the associations of left-hand digit ratio (2D:4D), digit length and puberty characteristics to show the role of prenatal hormones in development among Chinese girls. A total of 318 Chinese girls aged 8-15 years were recruited using a stratified cluster sampling method. The index finger (2D), ring finger (4D) of the left hand, oestradiol and testosterone were measured, and age at menarche (AAM), breast (high and low) and pubic hair (high and low) development were recorded. Girls who had experienced menarche had longer left digits (2D and 4D) and higher oestradiol, testosterone than those who had not. The high breast group had longer digits (2D and 4D), and higher oestradiol than the low breast group. With regard to pubic hair development, the high group had high 2D:4D, longer 2D and higher oestradiol, testosterone than the low group. After adjusting for oestradiol and testosterone, 4D length was positively related to occurrence of menarche. In addition, 2D and 2D:4D were significantly correlated with pubic hair development after adjusting for oestradiol, respectively. Prenatal hormone level may be related to the development of puberty characteristics among Chinese girls.

Puberty timing associated with obesity and central obesity in Chinese Han girls

BackgroundThere is growing scientific evidence supports a link between increased childhood adiposity and early onset of puberty in girls worldwide in recent decades. However, the data from Chinese girls remain ambiguous. The aims of this study were to estimate the puberty milestones and examine attainment of puberty associated with obesity and central obesity in Chinese Han schoolgirls.MethodsThe cross-sectional school-based study examined 2996 Han schoolgirls aged 9 to 19 years from 6 provinces in China. Trained clinicians assessed the girls for height, weight, waist circumference, Tanner stages of breast and pubic hair development, and menarcheal status. We classified girls as normal weight, overweight, or obese based on BMI, and as normal weight or central obese based on the waist-height ratio, then estimated and compared median age at a given Tanner stage or greater by weight class using Probit models.ResultsThe median age at menarche was 12.36 years. The median ages at breast stages(B) 2 through 5 were 10.03, 11.38, 13.39, and 15.79 years, respectively, and at pubic hair stages(PH) 2 through 5 were 11.62, 12.70, 14.38, and 16.92 years, respectively. Girls from urban areas experienced menarche, B3 and B4 stages, and PH3 through PH5 stages earlier. Girls with central obesity and overweight/obesity reached puberty earlier at almost every Tanner stage of breast and pubic hair than normal girls. Girls with obesity developed PH2 and PH3 earlier than their overweight peers. However, we did not find any significant differences between girls with overweight and obesity at all stages of breast development.ConclusionsChildhood obesity, including both overweight/obesity and central obesity, is associated with earlier attainment of puberty in Chinese Han schoolgirls.

Testosterone undecanoate supplementation together with human chorionic gonadotropin does not impair spermatogenesis in males with isolated hypogonadotropic hypogonadism: a retrospective study.

Gonadotropin therapy is commonly used to induce virilization and spermatogenesis in male isolated hypogonadotropic hypogonadism (IHH) patients. In clinical practice, 5.6%–15.0% of male IHH patients show poor responses to gonadotropin treatment; therefore, testosterone (T) supplementation can serve as an alternative therapy to normalize serum T levels and promote virilization. However, treatment with exogenous T impairs spermatogenesis and suppresses intratesticular T levels. This retrospective study aimed to determine whether oral testosterone undecanoate (TU) supplementation together with human chorionic gonadotropin (hCG) would negatively affect spermatogenesis in IHH patients compared with hCG alone. One hundred and seven IHH patients were included in our study. Fifty-four patients received intramuscular hCG and oral TU, and 53 patients received intramuscular hCG alone. The median follow-up time was 29 (range: 12–72) months in both groups. Compared with the hCG group, the hCG/TU group required a shorter median time to normalize serum T levels (P < 0.001) and achieve Tanner stage (III and V) of pubic hair and genital development (P < 0.05). However, there were no significant differences in the rate of seminal spermatozoa appearance, sperm concentration, or median time to achieve different sperm concentration thresholds between the groups. In addition, there were no significant differences in side effects, such as acne and gynecomastia, observed in both groups. This study indicates that oral TU supplementation together with hCG does not impair spermatogenesis in treated IHH patients compared with hCG alone, and it shortens the time to normalize serum T levels and promote virilization.

Association of phthalates, parabens and phenols found in personal care products with pubertal timing in girls and boys.

Are in-utero or peripubertal exposures to phthalates, parabens and other phenols found in personal care products associated with timing of pubertal onset in boys and girls? We found some associations of altered pubertal timing in girls, but little evidence in boys. Certain chemicals in personal care and consumer products, including low molecular weight phthalates, parabens and phenols, or their precursors, are associated with altered pubertal timing in animal studies. Data were from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) longitudinal cohort study which followed 338 children in the Salinas Valley, California, from before birth to adolescence. Pregnant women were enrolled in 1999-2000. Mothers were mostly Latina, living below the federal poverty threshold and without a high school diploma. We measured concentrations of three phthalate metabolites (monoethyl phthalate [MEP], mono-n-butyl phthalate and mono-isobutyl phthalate), methyl and propyl paraben and four other phenols (triclosan, benzophenone-3 and 2,4- and 2,5-dichlorophenol) in urine collected from mothers during pregnancy and from children at age 9. Pubertal timing was assessed among 179 girls and 159 boys every 9 months between ages 9 and 13 using clinical Tanner staging. Accelerated failure time models were used to obtain mean shifts of pubertal timing associated with concentrations of prenatal and peripubertal biomarkers. In girls, we observed earlier onset of pubic hair development with prenatal urinary MEP concentrations and earlier menarche with prenatal triclosan and 2,4-dichlorophenol concentrations. Regarding peripubertal biomarkers, we observed: earlier breast development, pubic hair development and menarche with methyl paraben; earlier menarche with propyl paraben; and later pubic hair development with 2,5-dichlorophenol. In boys, we observed no associations with prenatal urinary biomarker concentrations and only one association with peripubertal concentrations: earlier genital development with propyl paraben. These chemicals are quickly metabolized and one to two urinary measurements per developmental point may not accurately reflect usual exposure. Associations of peripubertal measurements with parabens may reflect reverse causality: children going through puberty early may be more likely to use personal care products. The study population was limited to Latino children of low socioeconomic status living in a farmworker community and may not be widely generalizable. This study contributes to a growing literature that suggests that exposure to certain endocrine disrupting chemicals may impact timing of puberty in children. This study was funded by the National Institute of Environmental Health Sciences and the US Environmental Protection Agency. The authors declare no conflicts of interest. N/A.

Association of blood leukocyte DNA methylation at LINE-1 and growth-related candidate genes with pubertal onset and progression

ABSTRACTPuberty is a developmentally plastic phase. Variations in pubertal tempo have implications for the risk of later adult diseases. Influences on pubertal tempo have been widely discussed, but the underlying biological mechanisms remain unclear. Epigenetic modifications are known to regulate development processes; they could play an important role in affecting pubertal outcomes. We conducted a population-based analysis to investigate the association of peripubertal blood DNA methylation at LINE-1 and growth-related candidate genes with pubertal onset and progression in healthy adolescents. The analytic sample included 114 males and 129 females aged 10 to 18 years. DNA methylation at growth-related candidate loci IGF2, H19, HSD11B2, as well as LINE-1 repetitive elements were quantified. Cox survival and ordinal regression models were used to examine sex- and locus-specific associations of epigenetic markers with pubertal development using physician-assessed Tanner stages and self-reported menarche, adjusted for covariates. Among boys, DNA methylation at H19 was associated with later pubarche. HSD11B2 methylation was associated with earlier onset of pubic hair and genitalia development and slower pubertal progression. IGF2 was associated with later onset of genital development. Among girls, LINE-1 methylation was associated with later onset of breast development. For each percent increase of methylation at H19, there was 5% increased odds in the earlier onset of breast development. DNA methylation of IGF2 was associated with earlier onset of pubic hair. DNA methylation at genes known to influence early-life growth may also influence pubertal outcomes.

Maternal age at menarche and pubertal development in sons and daughters: a Nationwide Cohort Study.

Is maternal age at menarche associated with pubertal development in sons and daughters? Maternal age at menarche was associated with pubertal development in both sons and daughters. Studies have shown that age at menarche is greatly inherited from mother to daughter, but it remains largely unknown to what extent age at menarche in mothers is associated with timing of puberty in sons. In this population-based study we used data from the Puberty Cohort nested within the Danish National Birth Cohort. Live-born singletons aged 11 were followed from 2012 to 2016. In total, 15 822 children (7697 sons and 8125 daughters) gave half-yearly information on puberty from the age of 11 years until full sexual maturity or 18 years of age through self-administrated questionnaires (participation rate 71%). Information on maternal age at menarche was reported by the mothers during pregnancy. Maternal age at menarche was used both as a continuous and as a categorical variable (earlier, same time or later than peers). A multivariable regression model for interval-censored data was used. Maternal age at menarche was positively associated with timing of genital development, pubic hair development, first ejaculation of semen, voice break, axillary hair development and acne in sons, and with timing of breast development, pubic hair development, menarche, axillary hair development and acne in daughters. In sons, the associations were of similar strength for all pubertal markers, whereas in daughters, the associations were strongest for breast development and menarche. Age at menarche was recalled during pregnancy. However, studies indicate that age at menarche is recalled moderately in adulthood. Information on puberty was self-reported, but inaccuracy of data would probably cause non-differential misclassification. Early maternal age at menarche was associated with earlier pubertal development, and late maternal age at menarche was associated with later pubertal development in both sons and daughters. The largest effect-estimates were for the associations between maternal age at menarche and the daughters' age at menarche and age at breast development. The study was funded by the Danish Council for Independent Research (4183-00152). There are no competing interests. N/A.

Timing of puberty in boys and girls: A population-based study.

BackgroundA secular trend towards earlier puberty has been observed in girls, while a similar trend has been more uncertain in boys. We estimated current ages at pubertal development in both boys and girls.MethodsIn this population‐based cohort study, 14 759 of 22 439 invited boys and girls born from 2000 to 2003 in the Danish National Birth Cohort gave half‐yearly self‐reported information on puberty from the age of 11.5 years and throughout puberty. This late start of follow‐up limits the estimation of age at onset of puberty but not later pubertal milestones. We estimated mean age at attaining the following pubertal milestones in years with 95% confidence intervals (CI): age at menarche, voice break, first ejaculation of semen and Tanner stages for pubic hair development and breast development or genital development. Further, the difference in mean age at menarche between mothers and daughters was estimated.ResultsIn boys, voice break occurred at 13.1 (95% CI 13.0, 13.1) years, first ejaculation of semen occurred at 13.4 (95% CI 13.3, 13.4) years, and Tanner Genital Stage 5 occurred at 15.6 (95% CI 15.5, 15.6) years. In girls, age at menarche occurred at 13.0 (95% CI 13.0, 13.1) years and Tanner Breast Stage 5 occurred at 15.8 (95% CI 15.7, 15.9) years. Daughters had menarche 3.6 (95% CI 3.1, 4.2) months earlier than their mothers had.ConclusionThese data indicate that age at menarche has declined and to some extent support a decline in age at attaining other markers of pubertal development among boys.

Vitamin D status and premature adrenarche.

Vitamin D, an important factor in calcium-phosphate homeostasis, has recently been suggested to play an important role in the pathogenesis of numerous chronic conditions such as hyperandrogenism. The aim of this study was to investigate the relationship between vitamin D status and premature adrenarche (PA). A total of 71 girls with PA and 52 healthy girls, as the control group, were recruited. Axillary and/or pubic hair development before the age of 8years was defined as PA. Bone age and anthropometric measures including height, weight, and body mass index (BMI) were obtained. 25-Hydroxyvitamin D (25(OH)D), fasting plasma glucose and insulin were measured. Vitamin D insufficiency was defined as <20ng/mL. The PA patients had older bone age, higher BMI standard deviation score, homeostasis model of assessment-insulin resistance (HOMA-IR), and androgen but lower 25(OH)D than the control group. HOMA-IR and dehydroepiandrosterone sulfate were also higher in PA patients with vitamin D insufficiency compared with those with normal vitamin D. There was a negative correlation between 25(OH)D and HOMA-IR. Low vitamin D is associated with PA; and insulin resistance may be a factor in this association.

Maternal Smoking During Pregnancy and Timing of Puberty in Sons and Daughters: A Population-Based Cohort Study.

Because early puberty has been linked to diseases later in life, identification of modifiable causes of early puberty is of interest. We explored the possible associations between maternal smoking during pregnancy and pubertal development in sons and daughters. Between 2012 and 2017, 15,819 children from the Danish National Birth Cohort, born during 2000–2003, provided half-yearly information on puberty from the age of 11 years. We estimated adjusted age differences (in months) at attaining various pubertal milestones, including Tanner stages, per 10 daily cigarettes smoked in the first trimester of gestation. In sons, exposure to smoking in utero was associated with earlier genital development (Tanner 2, −1.3 months, 95% confidence interval (CI): −2.5, 0.0; Tanner 5, −3.7 months, 95% CI: −5.3, −2.0), pubic hair development (Tanner 2, −1.8 months, 95% CI: −2.9, −0.6; Tanner 5, −2.9 months, 95% CI: −4.2, −1.7), and voice break (−2.4 months, 95% CI: −3.6, −1.3). In daughters, maternal smoking was associated with earlier breast development (Tanner 2, −3.4 months, 95% CI: −5.3, −1.5; Tanner 5, −4.7 months, 95% CI: −6.5, −2.9), pubic hair development stages 3–5 (Tanner 5, −2.5 months, 95% CI: −4.1, −1.0), and menarche (−3.1 months, 95% CI: −4.0, −2.3). Fetal exposure to tobacco smoke might advance timing of puberty in boys and girls.

Acetaminophen (Paracetamol) Exposure During Pregnancy and Pubertal Development in Boys and Girls From a Nationwide Puberty Cohort.

This study explored the association between exposure to acetaminophen during pregnancy and pubertal development using data from 15,822 boys and girls in the longitudinal Puberty Cohort, nested within the Danish National Birth Cohort. Use of acetaminophen was reported 3 times during pregnancy and 6 months postpartum. In total, 54% of mothers indicated use at least once during pregnancy. Between 2012 and 2017, sons and daughters provided information on a wide range of pubertal milestones—including Tanner stages, axillary hair growth, and age at menarche or voice break and first ejaculation—every 6 months from 11 years of age until full sexual maturation. Data were analyzed using a regression model for interval-censored data, providing adjusted mean monthly differences in age at attaining the pubertal milestones according to intrauterine cumulative (weeks) and trimester-specific acetaminophen exposure. Our results suggested a tendency towards slightly earlier attainment of almost all studied markers of female pubertal development with increasing number of weeks of exposure (i.e., about 1.5–3 months earlier age at pubic hair, axillary hair, and acne development comparing unexposed with those prenatally exposed for more than 12 weeks). Male pubertal development had no strong association with acetaminophen exposure.

Changes to sleep-wake behaviors are associated with trajectories of pubertal timing and tempo of secondary sex characteristics

We examined relations between sleep-wake behaviors and pubertal development from age 8.5 through 15.5 years in a US-based sample of 488 boys (75% White) and 478 girls (78% White). Applying conditional nonlinear growth models to 7-waves of longitudinal data, we examined how sleep-wake behaviors are related to individual differences in the developmental timing and tempo of secondary sex characteristics. For girls, results supported the hypothesis that circadian changes in bedtimes, wake times, sleep duration, and eveningness preference were uniquely related to development of discrete aspects of secondary sex characteristics. For boys, the hypothesis was generally not supported. Different endocrine systems related to discrete secondary sex characteristics may be responsible for more relations between sleep and pubic hair development than for breast or genital development. Further research into associations between adrenarche and sleep during puberty may help researchers understand more about the origins and timing of adolescent sleep changes.

Growth, sexual development and menstrual issues among girls with cerebral palsy – A cross sectional study in a tertiary care centre

IntroductionThere is paucity of literature and research on puberty among girls with cerebral palsy especially from India. Knowledge of sexual development and menstrual issues can guide towards better care for these girls. ObjectiveTo study the onset of sexual development and patterns of menstrual issues among girls with cerebral palsy who attended cerebral palsy clinic. MethodsA cross sectional study of 93 girls with cerebral palsy(GMFCS levels-I toV), aged 5–19 years, attending the cerebral palsy clinic at a tertiary care hospital, was conducted. Data was obtained by interviewing the parents of the girls with cerebral palsy using a semi structured questionnaire followed by examination of the girls. ResultsMean age of the girls in the study was 11.27 ± 4.46 yrs. The average height of the girls with cerebral palsy were found to be lesser than the published standards. 36(38.7%) girls had attained menstruation. Average age of menarche was 12.54 ± 1.37yrs. There was one case of delayed puberty. 75% of the girls had regular cycles while 47.2% had dysmenorrhoea. 69.4% used sanitary pads and mothers changed the pads in 38.8% of the girls. 58.3% of them had signs of vaginal infection while 25% of them showed signs of premenstrual syndrome. ConclusionGirls with cerebral palsy required extra support from their care-givers during the menstrual cycles. Usage of sanitary pads was not widely prevalent with signs of vaginal infection. Breast development was delayed but pubic hair development was found earlier among the study participants.

The association between pubertal status and depressive symptoms and diagnoses in adolescent females: A population-based cohort study.

BackgroundThere is an association between puberty and depression, but many things remain poorly understood. When assessing puberty in females, most studies combine indicators of breast and pubic hair development which are controlled by different hormonal pathways. The contributions of pubertal timing (age at onset) and pubertal status (stage of development, irrespective of timing) are also poorly understood. We tested the hypothesis that stage of breast development in female adolescents, controlled largely by increased estradiol, would be more strongly associated with depression than pubic hair development which occurs in both males and females, and is controlled by adrenal androgens. We investigated whether this association was independent of pubertal timing.MethodsROOTS is an ongoing cohort of 1,238 adolescents (54% female) recruited in Cambridgeshire (UK) at age 14.5, and followed-up at ages 16 and 17.5. Depression was assessed using the Mood and Feelings Questionnaire (MFQ) and clinical interview. Breast and pubic hair development were assessed at 14.5, using Tanner rating scales.ResultsFor each increase in Tanner breast stage at 14.5, depressive symptoms increased by 1.4 MFQ points (95% CI 0.6 to 2.3), irrespective of age at onset. Pubic hair status was only associated with depressive symptoms before adjustment for breast status, and was not associated with depression in males. The same pattern was observed longitudinally, and for depression diagnoses.LimitationsWe did not directly measure hormone levels, our findings are observational, and the study had a relatively low response rate.ConclusionsFemales at more advanced stages of breast development are at increased risk of depression, even if their age at pubertal onset is not early. Alongside social and psychological factors, hormones controlling breast but not pubic hair development may contribute to increased incidence of female depression during puberty.

Girls' Sleep Trajectories Across the Pubertal Transition: Emerging Racial/Ethnic Differences

PurposeThis study aims to examine the longitudinal association between puberty and sleep in a diverse sample of girls and explore racial/ethnic differences in this association. MethodsUsing latent growth curve modeling, the present study measured pubertal development (timing and rate) and sleep (wake time and bedtime) in 1,239 socioeconomically and ethnically diverse girls starting when they were 6–8 years old and followed longitudinally for up to 8 years. Pubertal assessment was conducted annually in clinic by physical examination, classified by sexual maturation stage for breast and pubic hair development by trained raters. ResultsIn line with previous research, black girls had the earliest pubertal development, followed by Hispanic, white, and Asian girls. Black girls, on average, reported significantly shorter sleep duration than Hispanic (β = −.20, p < .001), Asian (β = −.29, p = .002), and white (β = −.35, p < .001) girls. In a series of dual-process models, we found that early pubertal timing predicted shorter sleep duration for early-maturing black girls (breast development: β = .13, p = .005; pubic hair development: β = .14, p = .012). There was no evidence of any association between pubertal rate and sleep. All models controlled for family socioeconomic status and body mass index. ConclusionSleep is essential for many aspects of youth development, including emotional, cognitive, and physical functioning. Developmental changes associated with puberty may put some early maturing girls at risk of shorter sleep duration in adolescence and exacerbate racial/ethnic disparities in health and well-being.

Present Knowledge on the Etiology and Treatment of Adrenarche.

Premature adrenarche (PA) has been assumed to be a benign variant of normal pubertal development. Yet, current collective information suggests associations between PA and potential risks for development of polycystic ovary syndrome and adult diseases such as the metabolic syndrome. Adrenarche refers to the increased secretion of the adrenal androgen precursors DHEA, DHEAS, and androstenedione, which normally occurs in children at age 6-8 years. PA may be identified clinically by early pubarche, which is defined as the development of pubic or axillary hair before 8 years in girls or 9 years in boys. This paper will consider adrenal steroidogenesis, genetic markers, neurobiological changes, skeletal maturation, and associations with adult disorders. The differential diagnosis will be reviewed because PA remains a diagnosis of exclusion. Finally, synthesis of current knowledge regarding PA, suggestions for evaluation, management, and treatment are offered.

Environmental lead exposure and pubertal trajectory classes in South African adolescent males and females

The effects of environmental lead exposure in the neuro-endocrine system have been shown to impact the maturation and tempo of puberty development in adolescents. In low and middle income countries very little is known regarding the detrimental health effects of childhood lead exposure with regard to the tempo of puberty development. To help address this gap in data, we examined the association between lead exposure and puberty progression in males and females.Study participants from the urban Birth to Twenty Plus (BT20+) birth cohort in Soweto-Johannesburg, South Africa with data for blood lead levels at age 13years, cord blood lead levels, pubic hair development and breast development in females, and pubic hair development and genital development in males, were included in this study. The sample comprised 1416 study participants (n=684 females). Pubertal development trajectory classes were defined using Latent Class Growth Analysis. Data were examined for (i) an association between cord blood lead levels and pubertal trajectory classes; and (ii) an association between blood lead levels at age 13years and pubertal trajectory classes.In females, there was an association between adolescent elevated blood lead levels (≥5μg/dL) and lower level of maturation at age 9years and slower progression of pubic hair and breast development (relative risk ratio (RRR)=0.45, p<0.0001; 95% CI (0.29–0.68)) and (RRR=0.46, p<0.01; 95% CI (0.27–0.77)), respectively. In males, elevated blood lead levels at birth were associated with slower tempo of pubic hair development (RRR=0.20, p<0.05).Findings from this study suggest a possible role for environmental lead in altering pubertal development in South African adolescents as shown by slower tempo of progression through the Tanner stages pubertal development in females and males. There were also gender-differences between the effects of prenatal and postnatal lead exposure during pubertal development.

Impact of zinc on sexual maturation of female sickle cell anemia (SCA) children in Enugu, Southeast Nigeria

ABSTRACTAdolescence is an important developmental period of childhood. Good health and adequate nutrition consisting major food constituents and trace elements like zinc are fundamental for optimal sexual maturation. To determine the relationship between zinc levels and pattern of breast and pubic hair development, as well as menarcheal age of female SCA children aged 6–18 years and their matched controls with hemoglobin genotype AA. Cross sectional, case-control study. Information on biodata, age at menarche, medical and drug history as well as 24-hour dietary recall was documented using interviewer administered questionnaire. Sexual maturation was assessed using Tanner staging and zinc levels determined using Atomic absorption spectrophotometer. Eighty-one subjects were compared with 81 controls. There was significant delay in the mean age of attainment of various Tanner stages of breast and pubic hair in the subjects. Mean age of 14.81 ± 1.07 years at menarche in subjects was significantly higher than 12.62 ± 1.18 years in controls (p = 0.001). Serum zinc of 58.01 ± 10.58 µg/dl in subjects was significantly lower than 68.37 ± 8.67 µg/dl in controls (p = 0.001). Serum zinc levels were found to have a significant positive relationship with stages of sexual maturation and mean age at menarche. Reduced serum zinc in children with SCA was associated with delayed sexual maturation.

Age of pubertal events among school girls in Lagos, Nigeria.

Globally, there is a secular trend towards the reduced age for sexual maturity and menarche. This study aimed to determine the current age and factors associated with attainment of various stages of puberty in Nigerian girls. This study was a cross-sectional study involving 800 girls aged 6-15 years. The subjects were selected by stratified random sampling method from schools in Oshodi Local Government Area, Lagos State. They were interviewed and a physical examination was carried out to classify them into the various Tanner stages of breast and pubic hair maturational stages. The median age of girls at first stage of breast maturation (B2), first stage of pubic hair development (PH2) and at menarche were 9.0, 9.0 and 12.0 years, respectively. Breast development was significantly related to normal nutritional status (adjusted odds ratio [AOR] 4.5, p<0.001), overweight (AOR 40.2, p<0.001), obesity (AOR 154.2, p<0.001) and upper social class (AOR 15.7, p<0.031). Pubic hair development was significantly related only to overweight (AOR 4.7, p<0.007) and obesity (AOR 15.7, p<0.001) while achievement of menarche was significantly related to overweight (AOR 0.1, p=0.005), obesity (AOR 0.1, p=0.0009), high social class (AOR 4.7, p<0.001) and being a member of the Hausa tribe (AOR 35.8, p<0.029). There is decline in age of pubertal maturation of girls in Nigeria and the major contributory factors appear to be overweight and obesity. These findings are consistent with the pattern in developed countries.

Assessment of Anti-Mullerian Hormone (AMH) levels in a pilot cohort of peripubertal females: Correlation with sex maturity rating (SMR)

Abstract Objective Anti-Mullerian Hormone (AMH) is a quantitative marker for ovarian reserve found to be independent of the menstrual cycle. The objective of this study was to determine whether serum AMH levels correlate with sex maturity rating (SMR) in a group of peripubertal elementary school girls. Study design This cohort study was conducted in a tertiary care facility. Baseline blood sampling was obtained in 71 peripubertal healthy elementary school girls from Upper Egypt. AMH was measured using commercially available kit (DSL Inc., Webster, TX, USA). SMR was determined clinically through observations of pubic hair and breast development rated from 1 (preadolescent) to 5 (mature adult female). A bivariate analysis was conducted between age, weight, SMR, and the AMH level. Data was stratified for further analysis by SMR, and SMR 3 and 4 were combined to ensure suitable sample size. Statistical analysis was done using R software version 3.2.2 (R Foundation for Statistical Computing, Vienna, Austria). Results Seventy-one observations were analyzed with a mean age of 9.31 ± 1.80 years. Mean weight was 28.87 ± 7.45 kg, and the mean AMH level was 2.05 ± 0.52 ng/mL. SMR observations included 15 with SMR of 1 (21%), 26 with SMR of 2 (37%), 26 with SMR of 3 (37%), and 4 with SMR of 4 (6%). There were no significant associations between age, weight, SMR and AMH level. Upon stratifying the analysis by SMR, a significant correlation was found between age and AMH within the SMR of 3 and 4 grouping (rho = −0.4194, p = 0.02106). When considering all variables for regression it was found that the model that best fit the data was comprised of only an intercept term. Age, weight, and SMR were not included in the final regression model. Conclusion The correlation of AMH with an advanced stage of maturation (SMR 3&4) may reflect modest late pubertal AMH peaks in this population of females. The proportionate association of AMH with breast development, reflective of the gonadotropins and steroidogenic functions, supports its role as a marker of ovarian function in young females.