郑州市女童青春期性征发育流行病学特征分析

目的了解郑州市7～18岁女童青春期性发育状况,为界定我国儿童少年青春期性发育状态提供依据。方法结合2010年河南省学生体质健康调研结果,以郑州地区的调研点校为目标抽样点校,抽取9个城乡中小学校7～18岁女生每个年龄组110人,检查第二性征发育状况并询问月经初潮情况,运用概率单位回归法计算青春期重要发动事件平均年龄(中位年龄)及各主要百分位年龄。结果郑州市城市女生月经初潮平均年龄为12.09岁,乡村女生月经初潮平均年龄为12.23岁,初潮最小年龄为10岁;乳房发育Ⅱ,Ⅲ,Ⅳ,Ⅴ期的平均年龄分别为10.64,13.63,15.07和15.58岁,发育最早年龄为7岁;阴毛发育Ⅱ,Ⅲ,Ⅳ,Ⅴ期的平均年龄分别为13.44,14.80,15.42和15.95岁,发育最早年龄为9岁;腋毛发育Ⅱ,Ⅲ期的平均年龄为14.58,15.92岁,发育最早年龄为9岁。结论乳房最早开始发育,1.5 a以后半数出现月经初潮,然后阴毛、腋毛开始发育;第二性征发育和月经初潮年龄存在城乡差异。     

上海市女童青春期性发育指标年龄特征的流行病学研究

目的 了解目前上海市女童青春期各种性发育指标的年龄特征,分析其变化趋势,以进一步完善我国女性儿童青少年性发育评估体系。方法 采用分层整群抽样方法选取上海市中小学女生共1 675名,对乳房和第二性征发育水平进行Tanner分期评估,并记录月经初潮情况,概率单位回归法计算各种性发育指标的百分位年龄。结果 乳房达到TannerⅡ~Ⅴ期的中位年龄分别为8.26、10.62、12.88岁和16.64岁,阴毛达到TannerⅡ~Ⅴ期的中位年龄分别为11.48、12.71、15.23岁和19.07岁,腋毛开始发育和月经初潮的中位年龄分别为11.71岁和12.09岁。 结论 相对于同时期的其他国家,上海市女童的乳房发育较早,阴毛发育相对较晚,整个青春期性发育进程较为缓慢;长期趋势上,月经初潮年龄的再提前现象有待进一步观察。     

遗传与环境因素对女性青春期性征发育的影响

目的探讨遗传与环境因素对女性青春期性征发育的影响,为进一步深入研究女性青春期发育提供依据。方法以学校登记为基础,募集6~18岁女性双生子180对,其中单卵双生(MZ)132对,二卵双生(DZ)48对,按Tanner标准进行青春发育分期,询问有无月经初潮及月经初潮年龄。结果乳房开始发育的年龄为9~12岁,阴毛开始发育的年龄集中在9~13岁,月经初潮年龄多集中在11~13岁。月经初潮、性征发育一致率均为MZ>DZ,月经初潮的遗传指数为0.71,乳房和阴毛发育的遗传指数分别为0.34,0.45。月经初潮年龄的组内相关系数MZ>DZ(P<0.001),偶内均方MZ相似文献   

重庆城区儿童青春期发动时相现况及与肥胖的相关研究

目的调查重庆主城区8～19岁学生青春期发育现状及与肥胖的相关关系。方法采用多阶段分层整群抽样,对3046名中小学生进行青春期发育调查,内容包括青春期发动问卷(PDS)调查;体格检查包括身高、体重,男童外生殖器、阴毛、睾丸容积,女童乳房、阴毛发育检查;并运用概率单位回归法计算各分期年龄,采用Spearman秩相关分析青春期发动时相提前与肥胖的关系。结果女童乳房B2期平均年龄为11.51岁,阴毛FP2期平均年龄为13.93岁,月经初潮平均年龄为12.29岁;男童外生殖器G2期平均年龄为13.13岁,阴毛MP2期平均年龄13.62岁,睾丸容积达4ml平均年龄为11.67岁,男生首次遗精平均年龄为13.57岁;女生青春期发动提前组超重、肥胖比例大于发育正常组,且存在秩相关(P<0.01)。结论重庆城区女生青春期发动和性发育明显提前,且与肥胖存在相关关系。     

1587名女青少年青春发育调查报告

1993年3月～1993年5月我们对福建省3个城镇的部分地区1587名女青少年的青春发育情况进行调查。调查对象是在省城、县级市、小镇各选1所小学和1所初中,在校全部女生,年龄为7～16岁,共计1587人。调查项目;年龄(计算实足年龄)、身高、体重、乳房发育及阴毛生长分级。由妇产科医生询问月经史和体检,且按Tanner分期标准由专人分期,最后将调查数据输入电子计算机处理。女青少年青春发育各阶段年龄分布情况:身高猛增期平均为11岁。乳房Ⅰ级发育期平均年龄10.10岁,Ⅱ级发育期平均年龄12.01岁,Ⅳ级发育期平均年龄13.57岁,V级发育期平均年龄14.36岁。月经初潮平均年龄12.59岁。阴毛Ⅱ级发育期平均年龄12.54岁,Ⅲ级发育期平均年龄13.41岁,Ⅳ级发育期平均年龄14.09岁,V级发育期平均年龄14.49岁。     

根据青春期性生理、心理状况探讨开始性教育的年龄

调查分析了西安市1,592名6～18岁中、小学女生青春期性生理和心理现状,结果表明:乳房开始发育年龄最早为8岁,中位数年龄为10.52岁;月经初潮最早为10岁,平均年龄为12.61岁;学生迫切需要了解性生理卫生知识。从我国具体国情考虑,提出在本地区开始系统地进行青春期性教育的最适宜年龄在10岁左右。小学、中学学习阶段,是青少年性发育和心理发育的一个重要时期,适时进行性教育,有益子青少年身心健康,德、智、体、美全面发展。目前,关于性教育的开始年龄,国内外文献提法不一。为了解西安市青少年性发育和性知识普及的现状,探索在本地开展性教育的适宜年龄,于1986年10～11月对本市1592名女生进行了调查,结果表明:乳房开始发育年龄最早为8岁,中位数年龄为10.52岁;月经初潮最早为10岁,平均年龄为12.61岁;学生迫切需要了解性生理卫生知识。作者分析了适时开展这一工作的必要性、迫切性,提出了开始系统性教育的适宜年龄在10岁左右。     

早产与足月产儿青春期体格和性发育水平比较

目的 比较早产与足月产儿青春期体格发育和性发育水平，分析早产对青春期体格和性发育的影响。方法 对99名早产与99名足月产的12～15岁初中生进行身高、体重测定，同时评定第二性征发育水平，询问首次遗精和月经初潮的年龄。结果 2组青少年的身高、体重发育水平差异无统计学意义；早产男童的阴毛发育水平落后于足月产儿，首次遗精年龄大于足月产儿；早产女生的乳房发育水平落后于早产儿，月经初潮年龄大于足月产儿。结论 早产儿青春期虽然在体格发育方面赶上足月产儿，但性发育水平仍落后于足月产的同龄青少年。     

深圳地区8～14岁女性性发育现状调查及影响因素分析

目的:调查深圳地区8～14岁中小学女生青春期发育状况及影响因素,为制定干预措施提供科学依据。方法:采用整群分层随机抽样法对1362名女生进行青春期发育调查,内容包括身高、体重、乳房发育类型、胸围、腹围、臀围等测查及相关因素的问卷调查。结果:深圳地区28.7%的女生在12岁时乳房发育接近成熟。月经初潮年龄明显提前,最早8岁开始,65.8%的女生在12岁月经初潮。体重超重组、接触性信息组的Ⅳ～Ⅴ级乳房发育率比非超重和未接触组显著增加,月经初潮年龄提前(P<0.001)。运动少组Ⅳ～Ⅴ级乳房发育率比爱好运动组显著增加(P<0.001),月经初潮年龄提前(P<0.05)。结论:青春期启动和性发育明显提前,体重超重、运动少、接触性信息是青春期发育提前的主要诱因。     

仙居县某中学学生月经初潮与首次遗精年龄调查

目的了解仙居县学生月经初潮与首次遗精平均年龄,探讨其发育规律,有效地指导学校青春期健康教育。方法以分层整群随机抽样法,对16~18岁2 323名在校高中学生进行无记名问卷调查。结果女生月经初潮和男生首次遗精的年龄分别为12.64和13.51岁,女生月经初潮平均年龄小于全国乡村组调查月经初潮平均年龄0.02岁;男生首次遗精平均年龄小于全国乡村组调查首次遗精平均年龄0.72岁。结论该地区学生月经初潮、首次遗精年龄较早,社会经济和营养状况是影响男女学生性发育的重要因素,有关青春期性生理卫生知识的教育应从小学高年级开始进行较为合适。     

南钢中小学女生青春期发育的调查分析

采用一次性横断面调查方法对7~17岁中小学女生1522名进行了青春期发育调查。结果表明，女生青春期的开始以第二性征的出现为标志。乳房发育最早年龄为9岁。月经初期平均年龄为13.07岁，比12年前本地资料提前0.66岁。此外，探讨了月经初潮与第二性征的关系。同年龄组来潮与未来潮者的身高、体重间差异具有显著性。     

A study of developmental order of secondary sexual characteristics in Beijing girls

A six-year (1980-1986) study of the developmental status of the secondary sexual characteristics was made among 937 girls in Beijing. The mean age of the first appearance of the secondary sexual characteristics was breast 11.84 +/- 0.95 years, pubic hair 13.29 +/- 1.11 years, axillary hair 13.71 +/- 1.21 years; the average age of developmental maturation was breast 13.95 +/- 1.16 years, pubic hair 14.85 +/- 1.29 years, axillary hair 15.14 +/- 1.24 years. Their developmental order, as measured by the mean values of the groups, was breast, the first menarche (12.88 years), pubic hair, axillary hair. But when the individuals were examined only 22.85% was found to be in accord with the above order. The individual variation was very great. The course of development took about 3.5 years, but some needed one year to develop others six years. Some girls developed and finished at the same time, some finished earlier or later. Only a few girls have had no development of pubic hair and axillary hair until 18 years old.     

深圳市6～16岁儿童青春期性发育现况调查

目的 对深圳市6~16岁中小学生青春期性发育现况进行横断面调查, 为儿童卫生保健、青春期健康教育提供基础数据。方法 2017年9月-2018年9月期间,按整群抽样的方法,在深圳东、中、西三个行政区中随机分别抽取中、小学各2所。采用现况法获取第二性征发育(男童睾丸和阴毛发育,女童乳房发育和阴毛发育)数据,询问女童本人月经初潮年龄,共纳入10 674名6~16岁儿童。采用概率比回归模型进行统计分析,结果以中位年龄及对应的95％CI间表示。结果 男童睾丸容积达4ml和出现阴毛的年龄分别为10.1岁(10.0~10.2)和12.2岁(11.9~12.6)。女童乳房发育和出现阴毛的年龄分别为8.5岁(7.4~9.4)和10.6岁(10.5~10.7),初潮年龄为12.1岁(11.8~12.4)。与2005年全国流调数据相比,男、女青春期启动年龄分别提前0.4岁及0.7岁,女童初潮年龄提前0.1岁。结论 深圳地区6~16岁中小学生青春期启动年龄、女童初潮年龄与2005年全国九大城市儿童性征发育调查研究结论相似。     

Sexuelle Reifung von Kindern und Jugendlichen in Deutschland

Following the standstill in maturity acceleration in the eighties of the twentieth century, now a further shift in maturity development towards younger ages is the issue of an international and also German discussion. The collection of sexual maturity data in boys and girls as part of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS) is intended to pro vide population-representative information on sexual maturation and to evaluate associations between maturity status and selected health and social data. Girls were interviewed regarding their first menstrual period (menarche) and boys regarding voice change (status-quo method). Pubic hair was self-assessed by children and adolescents from 10 to 17 years of age, based on drawings of Tanner's defined developmental stages. The median age for menarche, for voice change and pubic hair stages were calculated using a logit model. At an age of 10 years, 42.4 % of girls and 35.7 % of boys report the development of pubic hair. At 17 years of age, the majority of girls and boys have reached the stages PH5 (girls 57.5 %, boys 47.8 %) and PH6 (girls 23.6 %, boys 46.5 %) according to Tanner. The average age for each pubic hair stage is lower in girls (PH2 10.8; PH3 11.7; PH4 12.3; PH5 13.4 years) than in boys (PH2 10.9; PH3 12.6; PH4 13.4; PH5 14.1). The median age at menarche is 12.8 years, the median for voice change (voice low) 15.1 years. Significant differences in age at menarche are found in girls depending on socioeconomic status (12.7/12.9/13.0 years for low/middle/high status) and between girls with and without migration background (12.5/12.9 years). No differences in age at menarche can be seen between East and West Germany or cities and rural areas. The association between maturity status and BMI is more pronounced in girls than in boys. Overall, the onset of maturity development in German children and adolescents is not significantly earlier than in other European studies.     

Blood lead levels and sexual maturation in U.S. girls: the Third National Health and Nutrition Examination Survey, 1988-1994

Using data from the Third National Health and Nutrition Examination Survey, we assessed measures of puberty in U.S. girls in relation to blood lead levels to determine whether sexual maturation may be affected by current environmental lead exposure. The study sample included 1,706 girls 8-16 years old with pubic hair and breast development information; 1,235 girls 10-16 years old supplied information on menarche. Blood lead concentrations (range = 0.7-21.7 micro g/dL) were categorized into three levels: 0.7-2.0, 2.1-4.9, and 5.0-21.7 micro g/dL. Sexual maturation markers included self-reported attainment of menarche and physician determined Tanner stage 2 pubic hair and breast development. Girls who had not reached menarche or stage 2 pubic hair had higher blood lead levels than did girls who had. For example, among girls in the three levels of blood lead described above, the unweighted percentages of 10-year-olds who had attained Tanner stage 2 pubic hair were 60.0, 51.2, and 44.4%, respectively, and for girls 12 years old who reported reaching menarche, the values were 68.0, 44.3, and 38.5%, respectively. The negative relation of blood lead levels with attainment of menarche or stage 2 pubic hair remained significant in logistic regression even after adjustment for race/ethnicity, age, family size, residence in metropolitan area, poverty income ratio, and body mass index. In conclusion, higher blood lead levels were significantly associated with delayed attainment of menarche and pubic hair among U.S. girls, but not with breast development.     

Timing of maturation and predictors of menarche in girls enrolled in a contemporary British cohort

This study describes the timing of puberty in 8‐ to 13‐year‐old girls enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) and identifies factors associated with earlier achievement of menarche. Women were enrolled during pregnancy and their offspring were followed prospectively. We analysed self‐reported Tanner staging and menstrual status information collected annually from daughters up to age 13. We used survival models to estimate median age of attainment of stage >1 and stage >2 of breast and pubic hair development and of menarche. We also constructed multivariable logistic regression models to identify factors associated with earlier achievement of menarche. About 12% of girls reported Tanner breast stage >1 at age 8; 98% of girls were above stage 1 by age 13. For pubic hair, 5% and 95% of girls had attained a stage >1 by 8 and 13 years, respectively. The estimated median age of entry into stage >1 of breast development was 10.14 years (95% confidence interval [CI], 10.08, 10.19), and for pubic hair development the median age was 10.92 years [95% CI, 10.87, 10.97]. One girl (out of 2953) had attained menarche by age 8; 60% had attained menarche by age 13. The estimated median age at menarche was 12.93 years [95% CI, 12.89, 12.98]. Prenatal predictors of menarche by age 11 (12% of girls) included earlier maternal age at menarche, high maternal pre‐pregnancy body mass index, smoking during the third trimester, and non‐white race; the single postnatal predictor was the girl's body size at 8 years. Age at attainment of breast and pubic hair Tanner stage and age at menarche in the ALSPAC cohort are similar to ages reported in other European studies that were conducted during overlapping time periods. The results also give added support to the strong influence of maternal maturation, pre‐adolescent body size and race on the timing of a girl's menarche. This cohort will continue to be followed for maturational information until age 17.     

贵阳市1 867名12～17岁女童性发育与血压关系

目的研究青春期女性性发育与血压的关系,以便为青少年生长发育的研究提供依据.方法 2002年9～11月对贵阳市12～17岁女童1 867名进行性发育评价,测量身高、体重、收缩压、舒张压和心率.结果同年龄、不同性发育水平(月经来潮与否),收缩压、舒张压均有随乳房和/或阴毛发育水平的增加而逐渐升高的趋势;但在同一乳房和/或阴毛发育水平时,上述2项指标并未呈现来潮者高于未来潮者的趋势.不同年龄、同一性发育水平时,除在性未发育个体的2项指标均有随年龄增长而增高的趋势外,其他性发育水平(月经来潮与否)的2项指标均未见有明显的规律性增加或下降.结论综合考虑性发育水平可较好地反映青春期女性个体的血压变化.     

Pubertal development and primary amenorrhoea

Puberty is the physical, emotional and sexual transition from childhood to adulthood. It involves five changes: breast, pubic hair, axillary hair development, the growth spurt and the onset of menstruation. In girls, pubertal development commences at around 8-9 years of age and lasts for 4-5 years. This review looks at the investigation into the absence of periods (primary amenorrhoea) if there is a failure to establish menstruation by the age of 14 years in girls without signs of secondary sexual development or by the age of 16 in the presence of normal secondary sexual characteristics. Primary amenorrhoea can be classified according to the presence or absence of secondary sexual characteristics. The onset of menstruation should usually occur within 2 years of the onset of breast development, pubic and axillary hair development and the growth spurt.     

云南省七个民族学生月经初潮、首次遗精与形态发育的关系

目的 了解云南省7个民族学生月经初潮和首次遗精与形态发育之间的关系,为研究学生生长发育规律和开展青春期性教育提供依据。方法 利用2014年全国学生体质健康调研数据,分析云南省7个民族学生月经初潮和首次遗精对身高、体重、胸围和维尔维克指数的影响。结果 男生性成熟年龄晚于女生,2014年云南省7个民族女生月经初潮半数年龄最小为汉族(12.28岁)、傣族(12.40岁),最大为哈尼族(13.06岁)、傈僳族(13.04岁),男生首次遗精半数年龄最小为佤族(13.43岁)、纳西族(14.01)岁,最大为傈僳族(15.29岁)、哈尼族(14.60岁);女生来潮组的形态发育状况好于未来潮组(P值均<0.05),男生已遗精组与未遗精组的差异,只有部分项目有统计学意义。结论 应针对不同性别、种族、地域特点,适时适量进行青春期性教育,加强少数民族学生的膳食营养,改变不合理膳食结构和饮食习惯,强化体育锻炼,更好地促进学生的生长发育。     

夜间人工光暴露与汉族女生月经初潮发生的关系

  目的  分析中国9~18岁汉族女生月经初潮发生情况与夜间人工光(artificial light at-night, ALAN)暴露的关系,为研究ALAN作为环境污染源对青春期启动的干扰作用机制提供线索,同时为环境ALAN控制和公共卫生政策的制定提供科学证据。  方法  采用2014年中国学生体质与健康调研数据,纳入月经初潮、身高、体重记录完整的9~18岁汉族女生74 483名。采用Pearson相关探索11岁汉族女生月经初潮发生率与ALAN暴露的相关性,并分别按照其所在地室外夜间灯光覆盖面积比例三分位数(0.16, 0.60)和夜间平均光强三分位数[0.97, 5.91 nw/(sr·cm)2]将研究对象分为3组,采用多因素Logistic回归模型分析ALAN暴露与月经初潮的关系。  结果  2014年中国汉族女生月经初潮中位年龄为12.18岁,11岁组月经初潮发生率为26.31%。控制体质量指数、当地人口总数、人均GDP的对数值后,11岁汉族女生月经初潮发生率与当地室外平均夜间灯光覆盖面积比例和夜间平均光强对数调整值均呈正相关(r值分别为0.29,0.30,P值均 < 0.05);所在地室外夜间灯光覆盖面积比例(OR值分别为1.28,1.52)和夜间平均光强(OR值分别为1.47,1.58)越高,11岁汉族女生月经初潮发生率越高(P值均 < 0.05)。  结论  夜间人工光暴露与11岁汉族女生月经初潮率存在正向关联,研究ALAN暴露可能为青春期启动机制提供线索,并为ALAN暴露对人群健康的影响提供科学证据。