Timing and determinants of age at menarche in low-income and middle-income countries

Introduction Understanding the timing and determinants of age at menarche is key to determining potential linkages between onset of puberty and health outcomes from a life-course perspective. Yet, we have little information in low-income and middle-income countries (LMICs) mainly due to lack of data...

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Main Authors: Tiziana Leone, Laura J Brown
Format: Article
Language:English
Published: BMJ Publishing Group 2020-12-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/5/12/e003689.full
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author Tiziana Leone
Laura J Brown
author_facet Tiziana Leone
Laura J Brown
author_sort Tiziana Leone
collection DOAJ
description Introduction Understanding the timing and determinants of age at menarche is key to determining potential linkages between onset of puberty and health outcomes from a life-course perspective. Yet, we have little information in low-income and middle-income countries (LMICs) mainly due to lack of data. The aim of this study was to analyse trends in the timing and the determinants of menarche in LMICs.Methods Using 16 World Fertility Survey and 28 Demographic and Health Surveys (DHS) from 27 countries, we analysed cohort trends and used fixed-effects models for DHS surveys to investigate sociodemographic and regional effects in the timing of age at menarche.Results Trends of the mean age at menarche across time within and between countries show a declining or stalling path. Results of the determinant modelling show the relationship with wealth changes over time although not consistently across countries. We see a shift from poorer women having earlier menarche in earlier surveys to richer women having earlier menarche in later surveys in Indonesia, the Philippines and Yemen, while in Egypt, the reverse pattern is evident.Conclusions There is a considerable gap in both literature and data on menarche. We see a trend which is declining rapidly (from 14.66 to 12.86 years for the 1932 and 2002 cohorts, respectively), possibly at a faster pace than high-income countries and with a strong link to socioeconomic status. This study calls for menarche questions to be included in more nationally representative surveys and greater use of existing data because of its impact on life-course health in fast-ageing settings. Further studies will need to investigate further the use of the age at menarche as an indicator of global health.
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spelling doaj-art-fbee9d3e6ac04b96bc1d159cce1019f62024-12-11T09:30:09ZengBMJ Publishing GroupBMJ Global Health2059-79082020-12-0151210.1136/bmjgh-2020-003689Timing and determinants of age at menarche in low-income and middle-income countriesTiziana Leone0Laura J Brown1International Development, London School of Economics and Political Science, London, UKInternational Development, London School of Economics and Political Science, London, UKIntroduction Understanding the timing and determinants of age at menarche is key to determining potential linkages between onset of puberty and health outcomes from a life-course perspective. Yet, we have little information in low-income and middle-income countries (LMICs) mainly due to lack of data. The aim of this study was to analyse trends in the timing and the determinants of menarche in LMICs.Methods Using 16 World Fertility Survey and 28 Demographic and Health Surveys (DHS) from 27 countries, we analysed cohort trends and used fixed-effects models for DHS surveys to investigate sociodemographic and regional effects in the timing of age at menarche.Results Trends of the mean age at menarche across time within and between countries show a declining or stalling path. Results of the determinant modelling show the relationship with wealth changes over time although not consistently across countries. We see a shift from poorer women having earlier menarche in earlier surveys to richer women having earlier menarche in later surveys in Indonesia, the Philippines and Yemen, while in Egypt, the reverse pattern is evident.Conclusions There is a considerable gap in both literature and data on menarche. We see a trend which is declining rapidly (from 14.66 to 12.86 years for the 1932 and 2002 cohorts, respectively), possibly at a faster pace than high-income countries and with a strong link to socioeconomic status. This study calls for menarche questions to be included in more nationally representative surveys and greater use of existing data because of its impact on life-course health in fast-ageing settings. Further studies will need to investigate further the use of the age at menarche as an indicator of global health.https://gh.bmj.com/content/5/12/e003689.full
spellingShingle Tiziana Leone
Laura J Brown
Timing and determinants of age at menarche in low-income and middle-income countries
BMJ Global Health
title Timing and determinants of age at menarche in low-income and middle-income countries
title_full Timing and determinants of age at menarche in low-income and middle-income countries
title_fullStr Timing and determinants of age at menarche in low-income and middle-income countries
title_full_unstemmed Timing and determinants of age at menarche in low-income and middle-income countries
title_short Timing and determinants of age at menarche in low-income and middle-income countries
title_sort timing and determinants of age at menarche in low income and middle income countries
url https://gh.bmj.com/content/5/12/e003689.full
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