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

Leone, T; Brown, LJ; (2020) Timing and determinants of age at menarche in low-income and middle-income countries. BMJ Global Health , 5 (12) , Article e003689. 10.1136/bmjgh-2020-003689. Green open access

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Abstract

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.

Type: Article
Title: Timing and determinants of age at menarche in low-income and middle-income countries
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjgh-2020-003689
Publisher version: https://doi.org/10.1136/bmjgh-2020-003689
Language: English
Additional information: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: child health, cross-sectional survey, public health, review
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10117999
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