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      Puberty signs and its relationship with lifestyle in 8-to-10-year-old girls: A descriptive-analytical study

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          Abstract

          Introduction:

          Declining the age of puberty causes many different physical, emotional and social changes that lead to negative consequences in adolescence and middle age. In the past 100 years, the average age of puberty has declined all over the world. External factors related to the lifestyle have effects on general sequences of puberty stages. The present study aimed to evaluate the puberty signs and their relationship with the lifestyle of 8-to-10-year-old girls in Ahvaz City.

          Materials and Methods:

          This descriptive-analytical study was conducted on 200 girls between 8 to 10 years of age from public schools of Ahvaz City from 2019 to 2020. Multi-stage cluster random sampling was used. The lifestyle questionnaire was distributed among the parents, and the children were examined physically for secondary sex characteristics. To analyze the data, SPSS 22 was used with the analyses and descriptive methods.

          Results:

          57.6% of the children experienced puberty, with an average onset age of 9.36 for girls. There was a significant relationship between the age of puberty onset and birth order ( P = 0.007), body mass index ( P = 0.001), nutrition of 8-year-old girls ( P = 0.008) and alcohol abuse of 9-year-old girls’ families ( P = 0.039). There was no significant relationship between the beginning age of puberty with environmental, social and psychological health.

          Conclusion:

          Results indicated a lower age of puberty onset compared to previous studies in the country. Therefore, these results can be a database for future analyses and comparisons.

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          Most cited references31

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

          Qiguo Lian, Yanyan Mao, Shan Luo … (2019)
          Background There 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. Methods The 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. Results The 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. Conclusions Childhood obesity, including both overweight/obesity and central obesity, is associated with earlier attainment of puberty in Chinese Han schoolgirls.
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            Causes, diagnosis, and treatment of central precocious puberty.

            Vinicius Brito, Jean-Claude Carel, Ana Latronico (2016)
            Central precocious puberty results from the premature activation of the hypothalamic-pituitary-gonadal axis. It mimics physiological pubertal development, although at an inappropriate chronological age (before 8 years in girls and 9 years in boys). It can be attributable to cerebral congenital malformations or acquired insults, but the cause in most cases in girls remains unknown. MKRN3 gene defects have been identified in familial disease, with important basic and clinical results. Indeed, genetic analysis of this gene should be included in the routine clinical investigation of familial and idiopathic cases of central precocious puberty. Gonadotropin-releasing hormone agonists are the gold-standard treatment. The assessment and management of this disease remain challenging for paediatric endocrinologists. In this Series paper, we describe current challenges involving the precise diagnosis and adequate treatment of this disorder.
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              Worldwide Secular Trends in Age at Pubertal Onset Assessed by Breast Development Among Girls: A Systematic Review and Meta-analysis

              Camilla Eckert-Lind, Alexander S. Busch, Jørgen H. Petersen … (2020)
              Has the age at onset of thelarche in girls changed within the past 4 decades? This systematic review and meta-analysis found that age at pubertal onset, with thelarche assessed by physical or clinical examination of the breast, decreased by a mean of almost 3 months per decade from 1977 to 2013. In most textbooks, thelarche among girls younger than 8 years is considered pathologic and warrants further investigations; therefore, a younger age at thelarche in girls in the general population will change current diagnostic decision-making in girls suspected to have puberty disorders. The initial clinical sign of pubertal onset in girls is breast gland development (thelarche). Although numerous studies have used recalled age at menarche (first menstruation) to assess secular trends of pubertal timing, no systematic review has been conducted of secular trends of thelarche. To systematically evaluate published data on pubertal timing based on age at thelarche and evaluate the change in pubertal onset in healthy girls around the world. A systematic literature search was performed in PubMed and Embase of all original peer-reviewed articles published in English before June 20, 2019. Included studies used clinical assessment of breast development in healthy girls and used adequate statistical methods, including the reporting of SEs or CIs. The quality of the articles was evaluated by assessing study design, potential sources of bias, main characteristics of the study population, and methods of statistical analysis. In accordance with PRISMA guidelines, all articles were assessed for eligibility independently by 2 authors. Weighted regression analysis was performed using a random-effects model. Studies examining age at thelarche (development of Tanner breast stage 2) in healthy girls. The literature search resulted in a total of 3602 studies, of which 30 studies fulfilled the eligibility criteria. There was a secular trend in ages at thelarche according to race/ethnicity and geography. Overall, the age at thelarche decreased 0.24 years (95% CI, −0.44 to −0.04) (almost 3 months) per decade from 1977 to 2013 ( P  = .02). The age at thelarche has decreased a mean of almost 3 months per decade from 1977 to 2013. A younger age at pubertal onset may change current diagnostic decision-making. The medical community needs current and relevant data to redefine “precocious puberty,” because the traditional definition may be outdated, at least in some regions of the world. This systematic review and meta-analysis evaluates published data on pubertal timing based on age at thelarche and evaluates the change in pubertal onset in healthy girls around the world.
              Article 0 comments Cited 107 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Family Med Prim Care
                Journal ID (iso-abbrev): J Family Med Prim Care
                Journal ID (publisher-id): JFMPC
                Journal ID (publisher-id): J Family Med Prim Care
                Title: Journal of Family Medicine and Primary Care
                Publisher: Wolters Kluwer - Medknow (India )
                ISSN (Print): 2249-4863
                ISSN (Electronic): 2278-7135
                Publication date (Print): August 2022
                Publication date (Electronic): 30 August 2022
                Volume: 11
                Issue: 8
                Pages: 4736-4742
                Affiliations
                [1 ] Department of Community Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
                [2 ] Master of Nursing Student, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
                [3 ] Nursing Care Research Center in Chronic Diseases, Department of Nursing, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
                [4 ] Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
                Author notes
                Address for correspondence: Dr. Ashrafalsadat Hakim, Nursing Care Research Center in Chronic Diseases, Department of Nursing, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. E-mail: hakim3448200@ 123456yahoo.com
                Article
                Publisher ID: JFMPC-11-4736
                DOI: 10.4103/jfmpc.jfmpc_2170_21
                PMC ID: 9638639
                SO-VID: 22944d43-7af4-4152-972c-b3f58b2bcac7
                Copyright © Copyright: © 2022 Journal of Family Medicine and Primary Care
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Date received : 01 November 2021
                Date revision received : 02 February 2022
                Date accepted : 15 February 2022
                Categories
                Subject: Original Article

                Keywords: early puberty,lifestyle,lifestyle dimensions,puberty
                Data availability:
                Keywords: early puberty, lifestyle, lifestyle dimensions, puberty

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