Pubertal development in Swiss girls

Pubertal development between 8 and 18 years is reported in 142 Swiss females of the First Zurich Longitudinal Study (1954-1980). Genital and pubic hair development were rated according to TANNER [9]. Pubertal development was initiated at the earliest between 8 and 9 years and at the latest between 14 and 15 years of age. The first secondary sex character in 53% of the girls was the onset of pubic hair development and in 18% the onset of breast development. In 29% both the initiation of breast and that of pubic hair development were observed as the first pubertal signs. Pubertal development was completed at the earliest between 12 and 13 years and at the latest between 17 and 18 years of age. Most pubertal stages of breast and pubic hair development tended to be reached at earlier ages than previously reported. Omissions of stages occurred only in a few percent of the girls. A notable exception was breast stage 4 which was absent in 33%. Reversions of stages, particularly of breast stage 5 to a lower breast stage, were occasionally observed. The mean duration of breast development was 3.2 +/- 1.4 years and pubic hair development 3.6 +/- 1.1 years. The mean age at menarche was 13.4 +/- 1.0 years. Menarche was reached on the average 2.2 years after the initiation of breast development and 2.7 years after the initiation of pubic hair development. In spite of large variations in timing and duration of pubertal stages some significant relationships were noted between the pubertal characters. Moderate correlations were found between the ages at initiation of breast and pubic hair development and menarche. The ages at completion of breast and pubic hair development, menarche and the age at which the peak of the adolescent growth spurt (PHV) was reached were highly correlated with each other. There was no significant relationship between the duration of breast development and that of pubic hair development. Furthermore, no clear relationship between the timing of pubertal development and its duration could be established. In contrast to previous reports the temporal relationship between pubertal development and the adolescent growth spurt was found to be similar in both sexes.     

Somatic puberty development in girls

In 142 Swiss girls of the First Zurich Longitudinal Study. The somatic pubertal development between 9 and 18 years is described. The mean chronological age at the onset of the pubertal growth spurt was 9.6 years (standard deviation 1.2 years). The peak of the pubertal growth spurt (peak height velocity: PHV) was reached at a mean age of 12.2 years (SD 1.0). The development of pubic hair started at a mean age of 10.4 years (SD 1.2), breast development at 10.9 years (SD 1.2) and the development of axillary hair at 12.0 years (SD 1.1). Menarche occurred 2.7 years (SA 1.1) after the initiation of pubic hair development and 2.2 years (SD 1.1) after the breast development had started. Menarche was noted at a mean age of 13.4 years (SA 1.1). At menarche the mean height was 156.9 cm (SD 6.3), the mean weight 45.5 kg (SD 6.8) and the mean bone age (according to Greulich and Pyle) 12.6 years (SD 0.8). With the onset of menarche 95.3% (SD 1.7) of adult height were reached; the corresponding remaining height gain was 7.8 cm (SD 2.8). Acne was observed in 81% and striae in 41% of the girls by 18 years.     

Pubertal characteristics among schoolgirls in Riyadh, Saudi Arabia

Puberty is the gradual transition period between childhood and adulthood. Many factors may contribute to the onset of puberty. The objective of the study was to determine the age of onset of secondary pubertal characteristics among Saudi Arabian girls. A cross-sectional study was conducted using a cluster sample design. Seven hundred and twenty-five schoolgirls between the ages of 6 and 16 years from diverse socioeconomic levels were included. During physical examinations, the height and weight of the girls were recorded, and the stages of breast and pubic hair development were determined according to Tanner stages; axillary hair development was determined according to modified stages. The median age at Tanner stage 2 for breast and pubic hair development was 10 years. The median age at stage 2 in modified scales for axillary hair development was 12 years. In conclusion, the median age of the onset of breast development at Tanner stage 2 for Saudi girls in Riyadh is lower than what has been reported in some countries in Europe, South Africa, Turkey and India but similar to girls in Hong Kong, China and white girls in the USA, which may support secular trends of an earlier onset of puberty.     

北京市儿童青少年女性青春期性征发育流行病学研究

摘要 目的：了解北京市6~18岁学龄女生青春期第二性征发育现状,以及人群性早熟发生率。方法：利用2004年北京市儿童代谢综合征调查（BCAMS）总样本中9 778名6~18岁中小学女生的青春期发育数据，用概率单位回归法计算月经初潮、乳房、阴毛不同发育时期的中位年龄。8岁前乳房或阴毛发育达Tanner II 期（B2,P2），或10岁前月经初潮者被定义为性早熟。结果：9 778名6~18岁中小学女生中城市人口5 040人，占总样本51.5%。北京市学龄女生月经初潮年龄平均为 （12.1±1.1）岁，城市女生（11.9±1.1）岁，农村女生（12.5±1.1）岁；女性第二性征开始发育年龄（总体/城市/农村）分别为，乳房：（9.5±1.2）岁/（9.3±1.1）岁/(9.6±1.2）岁；阴毛:(11.1±1.1）岁/(10.8±1.1）岁/(11.4±1.1）岁。城市女生月经初潮、乳房和阴毛发育均显著早于农村女生。月经初潮早发生率为0.79%，城市高于农村（1.03%：0.55%；x2=6.93，P<0.01）；乳房、阴毛早发育率分别为2.91%和0.22%。1962~1982年期间，北京女生月经初潮年龄平均每10年提前0.7岁（8.4个月）；近10年平均提前0.43岁（5.2个月）。结论：北京市城区女生青春期第二性征发育明显早于郊区县女生。月经初潮年龄提前的长期变化趋势依然存在，但近10年这一趋势趋于减缓。     

Onset of breast and pubic hair development in 1231 preadolescent Lithuanian schoolgirls.

BACKGROUND: Correct staging of puberty is essential in order to differentiate different pathologies, as various components of the endocrine system influence breast, pubic, and axillary hair development. AIMS: To determine the current timing of adrenarche and breast development in Lithuanian preadolescent schoolgirls. METHODS: Cross-sectional study of 1231 schoolgirls aged 7.0-11.6 years. Puberty was staged according to the method of Tanner. Mean age at entry into each pubertal stage was calculated by probit analysis. RESULTS: Of the 255 girls aged 7 years, two had premature adrenarche (0.8%) and one premature thelarche (0.4%). Mean age of onset of pubic/axillary hair development was 11.0 years, and for breast development (Stage 2) 10.2 years. Breast Stage 3 development was attained at 11.3 years and Stage 4 at 13.9 years. Mean BMI, height, weight, and systolic blood pressure SD scores were higher in pubertal than in prepubertal girls. Skinfold thickness was also significantly higher in girls with isolated adrenarche than in prepubertal girls. The increase in BMI and weight resulted from an increase in body fat as evidenced by measures of subscapular and triceps skinfold thickness. Girls with only signs of adrenarche or thelarche did not differ from each other from the anthropometric standpoint. CONCLUSIONS: Premature thelarche and premature adrenarche were relatively uncommon in this population. Pubertal onset was slightly earlier than the UK Tanner standards and tended to occur in girls with a higher BMI.     

Assessment of pubertal development in Egyptian girls

Puberty is a significant event of human growth and maturation associated with marked physiological and psychological changes. The aim of this study was to assess normal pubertal development in Egyptian girls to define normal, precocious and delayed puberty. The present study included a cross-sectional sample of 1,550 normal Egyptian girls of high and middle socioeconomic class living in Cairo. Their ages ranged from 6.5 to 18.5 years. Pubertal assessment was made according to Tanner staging. The mean menarcheal age (MMA) was estimated using probit analysis. Weight and height were measured and body mass index (BMI) was calculated. The mean age at breast bud stage (B2) was 10.71+/-1.6, pubic hair stage (PH2) was 10.46+/-1.36, while axillary hair stage (A2) was 11.65+/-1.62 and MMA was 12.44 years. The mean age at attainment of puberty was compared with those of other Egyptian studies and other populations. Girls of the present study started pubertal development and achieved menarche earlier than those of previous Egyptian studies confirming a secular trend. Differences between the present study and other worldwide studies can be attributed to various genetic, racial, geographical, nutritional, and secular trend factors.     

Pubertal development in The Netherlands 1965-1997

We investigated pubertal development of 4019 boys and 3562 girls >8 y of age participating in a cross-sectional survey in The Netherlands and compared the results with those of two previous surveys. Reference curves for all pubertal stages were constructed. The 50th percentile of Tanner breast stage 2 was 10.7 y, and 50% of the boys had reached a testicular volume of 4 mL at 11.5 y of age. Median age at menarche was 13.15 y. The median age at which the various stages of pubertal development were observed has stabilized since 1980. The increase of the age at stage G2 between 1965 and 1997 is probably owing to different interpretations of its definition. The current age limits for the definition of precocious are close to the third percentile of these references. A high agreement was found between the pubic hair stages and stages of pubertal (genital and breast) development, but slightly more in boys than in girls. Menarcheal age was dependent on height, weight, and body mass index. At a given age tall or heavy girls have a higher probability of having menarche compared with short or thin girls. A body weight exceeding 60 kg (+1 SDS), or a body mass index of >20 (+1 SDS), has no or little effect on the chance of having menarche, whereas for height such a ceiling effect was not observed. In conclusion, in The Netherlands the age at onset of puberty or menarche has stabilized since 1980. Height, weight, and body mass index have a strong influence on the chance of menarche.     

Secular trend in the sexual maturation of Southern Chinese girls

In 1993, a cross-sectional study of sexual maturation of normal Chinese schoolgirls was performed in Hong Kong. The aim of the study was to obtain an up-to-date reference for normal pubertal development in Chinese girls. Breast development was assessed in 3749 girls aged 7–19 y, and pubic hair rating was assessed in 3745 girls. Menstrual status was recorded in 6467 girls over 6 y of age. The median age of onset of puberty as indicated by breast stage II or above was 9. 78 (95% CI 9. 70–9. 85) y. The median age of onset of pubic hair development was 11. 64 (95% CI 11. 56–11. 72) y. The median age of menarche was 12. 38 (95% CI 11. 98–12. 78) years. Percentile values for the age at which each puberty staging appeared were constructed and incorporated into the height-for-age charts. When comparison is made with similar studies done in 1962 and 1979, a significant downward secular trend in sexual maturation is observed ( p < 0. 01). Except for breast development the downward secular trend in sexual maturation appears to be diminishing and may be coming to a halt in the Chinese girls in Hong Kong. Their median ages of sexual maturation are now among one of the earliest medians recorded in the world population studied.     

Pubertal stages 1980 of Stockholm schoolchildren

In March 1980 a cross-sectional study of the pubertal development of a sample of Stockholm schoolchildren was conducted. Breast development (B1-B5), pubic hair (PH1-PH5) and axillary hair (AH1-AH3) were rated in 138 girls, and genitalia development (G1-G5), pubic hair (PH1-PH5) and axillary hair (AH1-AH3) were rated in 116 boys according to the Tanner method. The girls'and the boys'ratings were done by one female and one male medically qualified expert respectively. When relating social class to age of pubertal stage no significant differences were found. Median ages for entry to successive pubertal stages as well as centiles were calculated by logistic regression. Girls were somewhat earlier in their breast and pubic hair development than Stockholm girls investigated in earlier studies; however, somewhat later in their development of axillary hair. The boys entered G2 earlier than boys studied in 1970 but entered G5 at exactly the same age, 15.1 years. Boys entered PH2 somewhat later than 1970 boys, but again reached PH5 at exactly the same age, 15.5 years. The present study is based on a more recent and somewhat larger sample of children drawn from a wider area of Stockholm than the earlier studies. It is therefore suggested that these values be used in the proposed new height and weight reference values for youth in Sweden.     

Age of puberty in a representative sample of Iranian girls

Background  To obtain normal references for growth and pubertal development in a given population, assessment of pubertal stages is of great importance. This study aimed to determine the age of appearance of secondary sexual characteristics in a representative sample of Iranian girls. Methods  This cross-sectional study was conducted during 2005–2006 in 3192 girl students, aged 6–17 years, in Isfahan, Iran. Participants were selected by multistage random cluster sampling from school students. Secondary sexual characteristics were evaluated by inspection and palpation, and were recorded according to Tanner staging. The self-reported date of menarche (if any) was recorded as well. Data were analyzed with Probit analysis based on the status quo method. Results  The median ages (10th–90th percentile) of Tanner stage 2 breast development (B2) and Tanner stage 2 pubic hair growth (PH2) were 10.14 years (8.33–11.95 years) and 10.78 years (9.09–12.48 years), respectively. The ages of the 3rd percentile for B2 and PH2 were 7.48 and 8.29 years, respectively. The median age of menarche among the 3192 girls who had experienced menarche was 12.65 years (11.18–14.11 years). Conclusions  The median age of puberty onset is 10.14 years, and the onset of puberty before 7.5 years is considered as precocious puberty in a representative sample of Iranian girls. The values obtained from the present study can provide baseline data for analysis of time trends, as well as for international comparisons.     

EVENTS OF PUBERTY IN 186 TASMANIAN SCHOOLGIRLS

This paper presents data on the physical effects of puberty in a group of Tasmanian schoolgirls. The mean age at menarche in 181 girls was 12.86 years. In the majority, the menarche occurred just before the attainment of maximum height and full sexual maturity as judged by breast development and pubic hair growth. A proportion of the girls (19 per cent) reported menstrual symptoms such as abdominal pain and irregularity.     

Pubertal maturation in girls and the relationship to anthropometric changes: pathways through puberty

OBJECTIVE: Patterns of pubertal maturation may have an impact on several risk factors associated with adult morbidity and mortality, such as obesity. We examined the relationship of the initial manifestation of puberty in girls with anthropometric measures, as well as age at menarche. METHODS: White females (n = 1166, ages 9 and 10 at intake) were followed with annual visits for 10 years. Physical examinations included height, weight, skinfold thicknesses, and pubertal maturation assessment. RESULTS: During the course of the study, 443 of 859 eligible females (51.6%) were observed to have asynchronous maturation in the development of puberty, that is, initial areolar/breast (thelarche pathway) or pubic hair (adrenarche pathway) development, without development of the other characteristic. Using a longitudinal regression model, significant interactions were noted between initial pubertal manifestation and years since onset of puberty on the following outcomes: sum of skinfolds thickness, percent body fat, waist-to-hip ratio, and body mass index (BMI). However, age of onset of pubertal maturation was the same in the 2 groups (10.7 years). Females in the thelarche pathway had earlier menarche (12.6 vs 13.1 years) as well as greater skinfolds, body fat, and BMI at the time of menarche. Females in the thelarche pathway also had greater body fat and BMI 1 year before puberty and throughout puberty compared with those in the adrenarche pathway. CONCLUSIONS: Females who enter puberty through the thelarche pathway, as compared with the adrenarche pathway, had greater sum of skinfold thicknesses, BMI, and percent body fat 1 year before the onset, as well as throughout, puberty. Because larger body composition and earlier age of menarche of females in the thelarche pathway parallel the epidemiologic profiles of women who are obese or at risk for obesity, these females may be at greater risk for adult obesity.     

Assessment of Pubertal Development in Iranian Girls

Objective

We estimated pubertal development of 7,493 normal Iranian girls aged 6 to 20 years in a cross-sectional study.

Methods

Pubertal stages were assessed according to Tanner. The mean ages to achieve secondary sexual characteristics as well as the mean age at menarche were estimated. Weight and height were measured and body mass index (BMI) was calculated. Reference curves for different breast stages and menarche were constructed. The percentiles for attaining each stage were compared to data proposed by Tanner.

Findings

The mean age at breast bud stage (B2) was 10.10, pubic hair stage (P2) was 9.83, and menarche age was 12.55 years. The anthropometric variables were interpreted in different maturity stages. The mean age at attainment of puberty was compared with those of other populations.

Conclusion

Not only the onset of puberty in Iranian girls but also the duration of puberty is similar to data from most other countries. A lower age limit for the definition of precocious puberty than the traditional 8 years is documented for Iranian girls. However, it should be noted that considering the rate of evolution of pubertal findings is more important than the age of their appearance.     

Declining age of puberty of school girls in southern Thailand

Background

Declines in the onset age of secondary sexual development have been reported in a number of recent studies in western and Asian countries. A study of Hat-Yai school girls in 1994 in Thailand showed that the ages at thelarche and menarche were 9.9 and 12.4 years, respectively. This study was to determine whether there was a decline in the average age of puberty in Hat-Yai school girls from 1994 to 2012.

Methods

A cross-sectional study was conducted in 2140 healthy Hat-Yai school girls, aged 6–18 years, from June 2011 to March 2012. Breast and pubic hair development was assessed by the Tanner staging method. Probit analysis was used to calculate the median ages of different stages of breast and pubic hair development, and the age of menarche.

Results

The median ages of girls having thelarche and menarche were 9.6 (95% CI, 9.4–9.8) and 12.2 (95% CI, 11.9–12.4) years, which declined from 9.9 (95% CI, 9.7–10.1) and 12.4 years (95% CI, 12.2–12.6) in the 1994 study respectively, however, without statistical significance. The youngest ages of girls who had breast stage 2 and menarche were 7.2 and 9.2 years, respectively. The final height at age 14 years in this cohort (157.3 cm) was 2.3 cm greater than that of girls in 1994 (155.0 cm).

Conclusions

From 1994 to 2012, the age at onset of thelarche and menarche of girls in Hat-Yai municipality declined by 0.2 and 0.3 years, respectively. The earlier age at onset of puberty had no effect on final adult height.     

广州女孩青春期发育模式的纵向研究

目的 纵向追踪广州女生性征发育和体格生长,了解青春发育模式及特点.方法 对广州市东、西、中部4所小学1992-2001年311名小学女生自一年级[(7.24±0.38)岁]起至其达到成年身高[238名,(15.72±0.84)岁],每年1次测量其身高、体重;并从三年级起至六年级,检查性征和询问初潮.分析乳房、阴毛发育、初潮、身高线性突增达峰速度(PHV)年龄、成年身高(FAH)及彼此间的关系.结果 (1)乳房发育达到B2期的年龄为9.83(9.33～10.33)岁,阴毛发育达到阴毛2期的年龄10.67(9.92～11.38)岁,初潮年龄(12.35±1.30)岁,均迟于2003年全国横向调查中广州地区女孩的调查结果.PHV年龄(10.52±1.07)岁.B2至PHV为1.00(0.50～1.50)年,B2至初潮为2.92(2.08～3.67)年,乳房发育达到B2期至FAH为(4.80～0.85)年.(2)FAH为(158.74±5.74)cm,高于1985年而低于2003年广州地区横向调查结果.(3)乳房发育达到B2期的年龄是初潮年龄的独立相关因素.(4)乳房发育每期持续年限、B2至PHV及B2至初潮间隔年限,与英国(1969年)、塞内加尔(1995-2000年)、美国(1986-1996年)的纵向调查结果相近.结论 近20年广州女生青春发育呈提前趋势,但成年身高却有增加;青春发育进展模式与世界各国历年调查结果相近.     

Study of pattern of sexual growth and factors influencing it in adolescent girls in Nagpur

Summary The pattern of sexual growth was studied in 1039 girls in Nagpur. The mean age at the first sign of breast development was 11.2 years. It appeared 1.77 years before the first sign of pubic hair and 2.75 years before the advent of the menarche The mean age at peak height velocity war 11.5 years, 0.3 years before the first external manifestation of sexual development. Nutrition and socio-economic status of the girl seemed to have good correlation with age at menarche while no correlation appearch between family size and age at menarche. From the Department of Preventive and Social Medicine, Government Medical College, Nagpur.     

Pubertal Characteristics in Girls of Qazvin Province,Iran

Objective

Puberty is a critical time between childhood and adulthood. Many studies have reported that the mean age of breast development is decreasing. The aim of this study was to provide updated data on the pubertal development of girls and to evaluate precocious puberty in our population.

Methods

This cross sectional study was conducted in 6 to 16 year old school girls during 2009-2010 in Qazvin. 2240 healthy girls from all geographical regions with every socioeconomic status were selected by a stratified multistage cluster design to obtain representative sample of population. A questionnaire including demographic data, anthropometric measurements, secondary sexual characteristics, menarche status and its onset was filled out for every participant. Secondary sexual characteristics including breast development (B_1–5) and pubic hair (PH_1–5) were evaluated according to Marshal and Tanner recommendation.

Findings

The mean±SD of height, weight, and BMI of participants was 139.7±14.5, 36.1±12.9 and 17.9±3.7 respectively. The mean age (10th – 90th percentile) of B₂ and PH₂ were 9.71(7.67–11.4) and 9.82 years (7.84–11.42) respectively. Mean age of menstruation was 12.52 years. The mean BMI was significantly higher in pubertal females comparing to prepubertal girls (P<0.001). Average duration of puberty (the time from initiation of puberty to menarche) was 2.81 years.

Conclusion

The mean age of pubertal onset in girls living in Qazvin is 9.71 years. Menarche occurs at mean age of 12.52 and onset of puberty earlier than 6.24 years will be precocious. We found that girls in Qazvin had a slightly earlier age of initiation of puberty and of menarche in comparison with other studies in Iran.     

A study of relation between physical growth and sexual maturity in girls--V

The findings indicate that sexual maturity would be initiated only after the attainment of requisite morphological body size such as weight on an average nearly 27 kg and height of 137 cm, irrespective of age and SES. The girls from LSES were chronologically older throughout the span of pubertal growth. However, they took lesser time to reach full maturity after the attainment of mid-pubertal growth compared to USES. Menarche appeared after attaining about a minimum weight of 35 kg, height of 143 cm and bicristal breadth is 24 cm. Its appearance followed the attainment of peak height velocity and 3rd developmental stage of breast and/or pubic hair. It, however preceded the attainment of weight and bicristal breadth peak velocities.     

Sequential changes at puberty in boys

A cross-sectional study of 1602 school boys of Sirohi town aged 8 to 18 yr for development of secondary sex characters using Tanner’s sexual maturity ratings carried out. Mean (±SE) age of onset of puberty is 9.95 (±0.06) yr and that of completion is 16.26 (±0.08) yr. Though boys of Rajasthan begin earlier to have pubertal changes, but total time taken to attain full maturation is longer than British. The Growth of genitalia starts first and completes in last, whereas that of pubic hair starts later but completes earlier. Facial hair and axillary hair follow pubic hair in development. Development of breast and apocrine function take place between stage 3 and 4 of genital growth.     

Pubertal development in Swiss boys

Pubertal development between 8 and 18 years is reported in 142 Swiss males of the First Zurich Longitudinal Study (1954-1980). Genital and pubic hair development were rated according to TANNER [14]. Testicular growth was assessed by comparative palpation with the orchiometer of PRADER [10]. The age at which pubertal development was initiated varied between the eighth and the fifteenth year of life. Reaching a testicular volume of 3 ml was found to be the most reliable indicator for the onset of pubertal development. The various pubertal stages of genital and pubic hair development tended to occur at earlier ages in this study than previously reported. This was particularly true for PH6 which was observed in 73% of the boys by age 20. Standard deviations of 1.0 to 1.5 years for the ages at which the pubertal stages were reached reflected the large variations in the timing of pubertal development. The mean duration of genital development was 3.5 +/- 1.1 years, of pubertal penis growth 1.8 +/- 0.7 years, of pubertal testicular growth 3.5 +/- 1.0 years and of pubic hair development 2.7 +/- 1.0 years. Moderate correlations were found between the ages at which genital development, pubic hair development and pubertal testicular growth were initiated. The ages at completion of these pubertal characters and the age at which the peak of the adolescent growth spurt was reached were highly positively correlated with each other. For a given stage of a pubertal character at least 80% of the children were within two successive stages of any other pubertal character, e.g. 87% of the boys were either in G2 or G3 when they reached PH2. No significant relationship between the durations of genital development, pubic hair development and pubertal testicular growth could be established. Likewise no significant relationship could be found between the timing and duration of pubertal development.