Menarcheal age in Cumbria

A survey of age at menarche in north-west England, how it is affected by family environment and how it affects physique, was carried out on a large sample of schoolgirls in Cumbria. Age at menarche shows no independent effect of social class, but is strongly influenced by family size and also partly by position in family. Similar results emerge from analyses of the status quo and recall data. Menarcheal status differences remain associated with pronounced differences in height and weight when all other variables are held constant, and there is a slight suggestion that the effect diminishes the later the age at which menarche occurs.     

Menarcheal age and socio-economic factors in Poland

BACKGROUND: Menarcheal age is the most important measure of sexual maturation in girls and a sensitive indicator of environmental conditions during childhood. OBJECTIVE: The study analysed the association between age at menarche and socio-economic characteristics (urbanization, population size, education of parents and number of children in the family). SUBJECTS AND METHODS: Questionnaire data were collected from 3271 female schoolchildren born between 1981 and 1984, living in three provinces of southern Poland. Menarcheal age was estimated by the recall method and based on the date of menarche given by the study participants. ANCOVA and multiple regression analyses were applied to test statistical significance of differences between groups. RESULTS: Girls from families with high socio-economic status experience menarche at an earlier age than girls from families with lower socio-economic status. However, depending on the geographical region and the population size, other factors influence menarcheal age. In the Krakow province, factors that significantly differentiate age at menarche are urbanization, father's education and number of children in the family; in the Opole province, these factors include urbanization and number of children in the family, while in the Nowy Sacz province, number of children in the family is significant. CONCLUSIONS: Socio-economic differences are greater in a large urban city (Krakow), and affect variation in age at menarche. However, within smaller populations (Opole, Nowy Sacz) living in towns and villages, the difference in age at menarche is less visible. In addition, variation between areas reveals a lower age at menarche in urban as compared with non-urban areas.     

Menarcheal age and socio-economic factors in Poland

Background:?Menarcheal age is the most important measure of sexual maturation in girls and a sensitive indicator of environmental conditions during childhood.

Objective:?The study analysed the association between age at menarche and socio-economic characteristics (urbanization, population size, education of parents and number of children in the family).

Subjects and methods:?Questionnaire data were collected from 3271 female schoolchildren born between 1981 and 1984, living in three provinces of southern Poland. Menarcheal age was estimated by the recall method and based on the date of menarche given by the study participants. ANCOVA and multiple regression analyses were applied to test statistical significance of differences between groups.

Results:?Girls from families with high socio-economic status experience menarche at an earlier age than girls from families with lower socio-economic status. However, depending on the geographical region and the population size, other factors influence menarcheal age. In the Krakow province, factors that significantly differentiate age at menarche are urbanization, father's education and number of children in the family; in the Opole province, these factors include urbanization and number of children in the family, while in the Nowy Sacz province, number of children in the family is significant.

Conclusions:?Socio-economic differences are greater in a large urban city (Krakow), and affect variation in age at menarche. However, within smaller populations (Opole, Nowy Sacz) living in towns and villages, the difference in age at menarche is less visible. In addition, variation between areas reveals a lower age at menarche in urban as compared with non-urban areas.

Résumé. Arrière plan: L’âge aux premières règles est une mesure importante de la maturation sexuelle des filles ainsi qu’un indicateur sensible des conditions du milieu au cours de l’enfance.

Objectif: Cette étude analyse l’association entre âge aux premières règles et facteurs socio-économiques (urbanisation, taille de la population, éducation parentale et nombre d’enfants dans la famille).

Sujets et méthodes: Des données par questionnaire ont été rassemblées sur 3271 écoliers habitant dans trois provinces du sud de la Pologne, nés entre 1981 et 1984. L’âge aux premières règles a été estimé par la méthode de mémorisation. Des analyses de régression multiple et de covariance (ANCOVA) ont été effectuées afin d’évaluer la signification statistique des différences entre groupes.

Résultats: Les filles de familles à statut socio-économique élevé sont plus précoces que celles de statut socio-économique défavorable, mais suivant la région et la dimension de la population, d’autres facteurs influencent l’âge aux premières règles. Dans la province de Cracovie, l’urbanisation, l’éducation du père et le nombre d’enfants dans la famille jouent un rôle significatif. Dans la province d’Opole, ce sont l’urbanisation, l’éducation du père et le nombre d’enfants dans la famille qui interviennent, alors que dans la province de Nowi Sacz, est significatif le nombre d’enfants dans la famille.

Conclusions: Les différences socio-économiques sont plus significatives dans une grande ville (Cracovie), alors que dans les ensembles populationnels plus restreints (Opole, Nowy Sacz), elles sont de moindre importance. Par ailleurs, la variation entre régions révèle un âge aux premières règles plus précoce chez les filles urbaines que chez les rurales.

Zusammenfassung. Hintergrund: Das Menarchealter ist das wichtigste Maß für die sexuelle Reife bei Mädchen und ein empfindlicher Indikator für Umweltbedingungen während der Kindheit.

Ziel: Die Studie analysierte die Beziehung zwischen Menarchealter und sozio-ökonomischen Kennzeichen (Urbanisation, Populationsgröße, Schulbildung der Eltern und Anzahl der Kinder pro Familie).

Probanden und Methoden: Mittels Fragebögen wurden Daten von 3271 Schülerinnen, geboren zwischen 1981 und 1984, aus drei Provinzen Südpolens erhoben. Das Menarchealter wurde retrospektiv erfragt und basiert auf Angaben zur Menarche von den Studienteilnehmerinnen. Es wurden ANCOVA und multiple Regressionsanalysen verwendet, um Unterschiede zwischen den Gruppen auf statistische Signifikanz zu testen.

Ergebnisse: Mädchen aus Familien der oberen sozio-ökonomischen Schicht menstruieren früher als Mädchen aus Familien niederer sozio-ökonomischer Schichten. Je nach geographischer Region und Populationsgröße gibt es jedoch noch weitere Faktoren, die das Menarchealter beeinflussten. Faktoren, die in der Provinz Krakau signifikanten Einfluss auf das Menarchealter zeigen, sind Urbanisationsgrad, Schulbildung des Vaters und Anzahl der Kinder in der Familie; in der Provinz Oppeln beinhalten diese Faktoren den Urbanisationsgrad und die Anzahl der Kinder in der Familie, während in der Provinz Novy Sacz nur die Anzahl der Kinder in der Familie Signifikanzniveau erreichen.

Zusammenfassung: Sozio-ökonomische Unterschiede sind in einer Großstadt (Krakau) größer und nehmen Einfluss auf die Variation des Menarchealters. In den weniger umfangreichen Populationen (Oppeln, Novy Sacz) aus kleineren Städten und Dörfern ist dagegen der Unterschied im Menarchealter weniger offensichtlich. Darüber hinaus zeigt die Variation zwischen Regionen, dass das Menarchealter in städtischen Gegenden niedriger ist als in ländlichen.

Resumen. Antecedentes: La edad de menarquia es la medida más importante de la maduración sexual en chicas y un sensible indicador de las condiciones ambientales durante la infancia.

Objetivo: El estudio analizó la asociación entre la edad de menarquia y características socioeconómicas (urbanización, tamaño poblacional, educación de los padres y número de hijos en la familia).

Sujetos y métodos: Los datos del cuestionario se recogieron en 3271 niñas escolares nacidas entre 1981 y 1984, que residían en tres provincias del sur de Polonia. La edad de menarquia se estimó por el método retrospectivo y se basó en la fecha de menarquia proporcionada por las participantes en el estudio. Se aplicaron los análisis ANCOVA y de regresión múltiple para comprobar la significación estadística de las diferencias entre grupos.

Resultados: Las chicas de familias con un nivel socioeconómico elevado experimentan la menarquia a una edad más temprana que las de familias con un nivel socioeconómico bajo. Sin embargo, dependiendo de la región geográfica y del tamaño poblacional, existen otros factores que influyen sobre la edad de menarquia. En la provincia de Cracovia, los factores que producen diferencias significativas en la edad de menarquia son la urbanización, la educación del padre y el número de hijos en la familia; en la provincia de Opole, estos factores incluyen la urbanización y el número de hijos de la familia, mientras que en la provincia de Nowy Sacz, es significativo el número de hijos por familia.

Conclusiones: Las diferencias socioeconómicas son mayores en una gran urbe (Cracovia) y afectan a la variación en la edad de menarquia. Sin embargo, dentro de poblaciones más pequeñas (Opole, Nowy Sacz), viviendo en pueblos y aldeas, la diferencia en la edad de menarquia es menos evidente. Además, la variación entre áreas revela una menor edad de menarquia en el medio urbano comparado con las áreas no urbanas.     

Menarcheal age in Oslo during the last 140 years

Data from maternity clinics have been used to study the trend in menarcheal age among girls born in Oslo after 1840. The investigation was based on recordings from approximately 50 women from each year. The women were divided into social categories according to their own or their husband's occupation. The results show a trend toward earlier maturation within the working class, which is characterized by two periods of rapid fall in menarcheal age. The first period covers women born between 1860 and 1880, and shows a fall in menarcheal age from about 15·6 to about 14·6 years. During the second period of rapid fall, which covers women born between 1905 and 1940, the menarcheal age was further reduced from about 14·6 to 13·3 years. The age at menarche has been stable at about 13·3 years for women born after 1940.

These results contrast with those of some earlier studies of the menarcheal age in Norway. However, it is shown that the discrepancies between these investigations and our own disappear when the same computational methods and the same interpretation of the age recordings are used.     

Menarcheal age for Norwegian women born 1830-1960

Data from birth records from the maternity hospitals in the three main cities in Norway have been used to study the trend in menarcheal age for women born from about 1830 to about 1960. The investigation is based on a sample of 200-300 records around every 10th year from each of the three clinics in partly overlapping time periods relating to a total of 9152 women. The recollected age at menarche fell from just above 16 years for women born around 1830 to just above 13 years for those born around 1960, the decrease being not totally linear. These results correspond closely with a previously published investigation from Oslo from about the same period of time (Brudevoll, Liest?l and Wall?e, 1979), but our results, which cover more of Norway, show a more linearily shaped curve than the results covering only Oslo. We have also analysed the relationships of several independent variables to menarcheal age, using multivariate linear regression methods. Besides the woman's year of birth, which was the most important variable throughout the whole period of time, various geographical variables were found to be of moderate importance. Being born in the countryside and in towns other than Oslo and Bergen led to a slightly higher age at menarche. No significant difference between Oslo, Bergen and Trondheim was detected except for the period up to about 1880 where the Bergen women had about 2.6 months earlier menarche than the Oslo women. Married women amongst the sample had experienced menarche a little earlier than the unmarried, and among married women there was an association between occupation and menarcheal age, women from the lowest social classes having the latest ages at menarche. The importance of these socially related parameters declined with time, and for women born after 1945 the difference seemed to have disappeared. The age at menarche was found to be positively related to a woman's age at first birth; the further back in time the stronger the relation. In addition, delayed age at menarche was also found to be associated with irregularities in the menstrual cycles in later life.     

Menarcheal age in Turkey: Secular trend and socio-demographic correlates

Background: Menarche is an important indicator for assessing the developmental status of pubertal girls. Despite its importance, there is no nationwide information on menarcheal age in Turkey.

Aim: This paper is the first attempt to examine age at menarche for Turkey as a whole. The aim is to present the secular trend of menarcheal age and variations across different socio-demographic groups.

Methods: Data were employed from the Turkey Demographic and Health Survey, 2008. Mean menarcheal ages were estimated for birth cohorts and socio-demographic sub-groups. The pace of decline in menarcheal age has been estimated using multiple linear regression analysis, controlling for year of birth and other variables.

Results: Mean age at menarche was estimated as 13.30 (95% CI = 13.26–13.35). It was estimated as 13.17 years (95% CI 12.95–13.38) for the youngest birth cohort (1989–1993), as opposed to 13.44 (95% CI 13.37–13.52) years for the cohort born in 1959–1968.

Conclusion: Regression analysis indicated a decrease of 1.44 months per decade, providing evidence of a secular trend in menarcheal age in Turkey. Further results suggested childhood place of residence, education, welfare status and number of siblings to be significantly associated with menarcheal age.     

Menarcheal age and habitual miscarriage: evidence for an association

Among women who habitually miscarried (two or more miscarriages) we observed a modest association for increased risk of miscarriage of first pregnancies in those with younger (especially less than or equal to 11 years) and older (greater than or equal to 16 years) menarcheal age (quadratic G2 = 3.49, P = 0.062). No associations of menarcheal age with first pregnancy miscarriage were observed when analysed by age at first pregnancy, or with pregnancy number among women with only one miscarriage. Unusually early or late menarcheal age appears to increase the risk of miscarriage of the first pregnancy but only among women who will go on to habitually miscarry.     

Menarcheal age and spontaneous abortion: Further evidence for a connection

This paper examines the association between menarcheal age and risk of spontaneous abortion with a data set collected in Limon, Costa Rica. The Limonense sample differs from those previously reported in terms of age, socioeconomic and ethnic background. Thus, the sample is excellent to test whether menarcheal age and risk of miscarriage are associated in a nonindustrialized group as they appear to be in industrialized samples. Females who experienced one or more miscarriages have a significantly earlier age at first menses than those who did not. The results also indicate that a possible reason for this association is that early maturers tend to experience first pregnancy at an earlier age than do late maturers.     

Diurnal variations in suicide by age and gender in Italy

BACKGROUND: Recent Italian statistics on suicide distribution by time of day also report data on gender and age of victims, factors which have been shown to influence the seasonal distribution of suicide and which could also affect the influence of biological circadian rhythms on suicidal behaviour. This study aims to identify and evaluate any diurnal variations that may be present in suicide occurrence by age and gender in Italy, considering data from 1994 to 1997. METHODS: The null hypothesis that there are no variations in the distribution of suicides by time of day (or over the three major periods of the day: morning, afternoon, evening/night) was tested with the chi2 goodness-of-fit test and with ANOVA. RESULTS: A clear diurnal variation in the distribution of suicides over time can be observed for both genders, with a peak in the late morning (08:00-11:00 h), and a subsequent decrease to a trough in the night hours. This trend varies with age for both genders: in particular, the age groups 45-64 and 65+ show a clear suicide peak in the morning (08:00-11:00 h), whereas younger people have a peak number of suicides in the late afternoon (16:00-19:00 h). Adults (25-44 years old) show an intermediate trend, with a less pronounced peak between the morning and early afternoon hours. The observed trend is more marked among males; however, the distribution of suicides by time of day is clearly congruent by age between both genders. CONCLUSIONS: Diurnal variation in suicide occurrence by age group may be affected by factors distributed unevenly across age groups. In particular, age distribution of disorders leading to suicidal ideation, and the sensitivity of biological systems of different age groups to environmental cues may affect each group's risk of suicide. Socio-relational factors are also likely to contribute to diurnal variation in suicide risk by age and gender. Children and adolescents can generally be presumed to be at school during the morning, therefore their opportunity for self-harm is restricted to afternoon hours. The elderly, on the other hand, may find themselves alone in the morning, when family and friends spend more time away from home due to daily work activities. LIMITATIONS: Data are based on time of death and not on presumed time of the suicidal act. For suicides committed by certain methods (e.g., poisoning) there may be a considerable difference between time of act and time of death. CLINICAL RELEVANCE: The existence of a temporal window in suicide risk implies an improvement in the surveillance of people at risk of suicide and greater attention to chronobiological factors affecting those suffering from mental disorders leading to suicide ideation.     

Menarcheal status and bone development in Guatemalan girls

Premenarcheal and postmenarcheal girls of the same chronological ages (11.5–15.5 years) and from the same villages in Guatemala differ significantly in patterns and mean levels of several measures of bone development. Stature, metacarpal dimensions, bone mineral content and bone mineral density from single photon absorptiometry, and total alkaline phosphatase activity are significantly associated with menarcheal status. Controlling for chronological age, there is significant variation in bone development associated with variation in menarcheal status. Unequivocal presentation and analyses of bone development in adolescent girls require that menarcheal status or another adequate measure of maturation be considered. © 1993 Wiley-Liss, Inc.     

Trend of Menarcheal Age among Korean Girls

BackgroundMenarcheal age has been decreasing worldwide. However, few recent studies have observed trends in menarcheal age in larger populations, and the cutoff age for early menarche remains unclear. Therefore, we aimed to analyze recent trends of menarcheal age and to determine the cutoff age of early menarche based on nationally representative data.MethodsWe conducted a cross-sectional study of 351,006 Korean girls aged 12–18 years who were born in 1988–2003 based on the data of the 2006–2015 Korea Youth Risk Behavior Survey. We identified the distribution of age at menarche using the complex sample Cox regression model. Trends in the prevalence of early menarche were determined using the complex sample linear model.ResultsNinety-five percent of all the participants reported they had experienced menarche. The mean menarcheal age was 13.0 years (95% confidence intervals [CIs], 12.92–13.04) for girls born in 1988 and decreased to 12.6 years (95% CI, 12.54–12.61) for girls born in 2003. The cutoff age (the 3rd percentile value) for early menarche was 10.5 years during the study period. The prevalence of early menarche significantly increased from 1.8% in 2006 to 3.2% in 2015 (P-for-trend < 0.001). Downward trends of menarcheal age were noted across all body mass index groups, and this trend was most prominent in the obese group.ConclusionWe reported an ongoing downward trend in menarcheal age in Korean girls born in 1988–2003, decreasing by 0.4 years over the 15 years.     

Effectiveness of HPV vaccination in women reaching screening age in Italy

Background and objectivesA randomized trial was conducted in Tuscany, Italy, to evaluate the effectiveness of HPV vaccination for 25 year old (yo) women who attend at the first time cervical cancer screening. The trial also evaluated immune response after vaccination, reductions of cytological abnormalities and the impact of vaccination on screening activity.Study designDuring 2010–2011, all 25 yo women who were invited to the Florence cervical cancer screening programme were also asked to participate in the trial. Enrolled women were randomized into study and control groups. Those in the study group were offered HPV vaccination after the usual Pap test. The cytology distribution and prevalence for any high risk (hr) HPV type were compared at the subsequent screening round in an intention-to-treat analysis. The impact of HPV vaccination was evaluated per protocol comparing vaccinated women with the control group.ResultsOur results showed a reduction in HPV prevalence at recall for any hr-HPV type but it was not statistically significant, being 17.1% vs 21.4%, p = 0.20 in the study and control groups, respectively. If we restricted the analysis to vaccinated women, strong reductions of the HPV 16,18,31,33,45 and HPV 31,33,45 infections were observed, being 5.3% vs 12.8%, p < 0.01 and 2.1% vs 6.5%, p = 0.02, respectively. Significant reductions for any hr-HPV infection and for HPV 16 infection were also observed in women HPV 16/18 negative at enrolment, being 12% vs 21.4%, p < 0.01 and 0.6% vs 6.7%, p-value < 0.01, respectively. In women hr-HPV negative at enrolment no infections due to HPV 16 or HPV 18 were observed and there was a big reduction for any hr-HPV infection (7.1% vs 21.4% p < 0.01). A strong antibody response was observed not only for HPV 16 & 18 but also for their related types.ConclusionsOur findings suggest that HPV vaccination at the age 25 is beneficial if it is offered to hr-HPV negative women. Our data will assist in developing a cost effectiveness model for choosing the best strategy to integrate screening and vaccination for the coming years.Clinical trial registration number is NCT02296255.     

Determinants of age at menopause in women attending menopause clinics in Italy

OBJECTIVE: We analysed the mean age at menopause and its determinants in 31,000 women attending menopause clinics in Italy. DESIGN: Between 1997 and 2003 we conducted a large cross-sectional study on the characteristics of peri- and post-menopausal women attending a network of first-level outpatient menopause clinics in Italy for general counseling or treatment of menopausal symptoms. Spontaneous menopause was defined as natural cessation of menses for 12 or more months. A total of 31,834 women with spontaneous menopause entered the study. RESULTS: The mean age at spontaneous menopause was 51.2. The age at menopause did not markedly changed with cohort of birth. Higher education was associated with lower age at menopause (51.1 in women with low education versus 51.3 for women with high school or university degree, p<0.05). A higher body mass index (BMI) was associated with later age at menopause. Smokers reported a lower age at menopause (51.2 in nonsmokers versus 51.1 in smokers, p<0.05). A later age at menarche was associated with a later age at menopause. Likewise, lifelong irregular menstrual cycles and higher parity were related with later age at menopause. No association emerged between ever oral contraceptive use and age at menopause. CONCLUSIONS: Low educational level, lower BMI, smoking, early menarche, nulliparity and regular cycles are independently associated with lower age at natural menopause in a large sample of women attending menopause clinics in Italy. However, in absolute terms the effect of these factors in our sample is very small.     

Canine and feline infections by cardiopulmonary nematodes in central and southern Italy

Capillaria aerophila, Aelurostrongylus abstrusus, Angiostrongylus vasorum and Dirofilaria immitis are cardiopulmonary nematodes affecting dogs and cats and presently emerging in several countries. The results obtained in 2009 - 2010 during a study aiming to investigate the occurrence of these nematodes in regions from Central (Marche and Abruzzo regions--Sites A and B, respectively) and southern (Apulia--Site C) Italy are here reported. A total of 534 and 436 individual faecal samples collected from dogs and cats were examined, together with 471 and 34 faecal environmental samples taken from dog shelters and catteries. One hundred and ninety-two individual blood samples were also collected from dogs. Faeces were examined using copromicroscopical flotations and Baermann technique, whereas blood samples were tested by Knott's method. Eggs of C. aerophila were detected in 1.48 % and 20 % (Site A), 8.67 % and 2.71 % (Site B), and 16.67 % and 0 % (Site C) of individual and environmental canine samples. C. aerophila was found in 2.90 % (Site A), 3.03 % (Site B) and 14.29 % (Site C) of individual cats. Larvae of A. vasorum were found in 0.96 % and 2.48 % of individual and environmental samples from Site B, respectively, while those of A. abstrusus in 1.82 % (Site A) and 9.96 % (Site B) of individual faeces. Microfilariae of Dirofilaria immitis, identified on the basis of key morphological and morphometric features, were detected in 2.56 % of samples collected from Site B. Despite the small sample size, these results indicate that cardiopulmonary nematodes occur in Central and southern Italy, thus they should be included in the differential diagnosis of pet cardiorespiratory diseases. Larger surveys are necessary to gain more information on the diffusion of these parasites, especially for C. aerophila and A. vasorum, for which the actual distribution is poorly known.     

Prevalence and molecular characterization of Giardia duodenalis from sheep in central Italy

Giardiosis in domestic ruminants is an important parasitic disease and it has been shown to impair growth in lambs, thus constituting a disease of economic concern. In Europe, surveys on the prevalence of giardiosis in sheep are limited. In order to obtain additional information on the presence of giardiosis and on the potential zoonotic role of Giardia duodenalis affecting sheep in central Italy, faecal samples of 325 native sheep from 20 farms in Abruzzo region (Italy) were examined for the presence of Giardia and the isolates were genotyped and sequenced. G. duodenalis cysts were detected in five of the 325 sheep (1.5%) (mean of 450 cysts/g) coming from two farms. The 770-bp fragment of the glutamate dehydrogenase gene and the 753-bp fragment of the -giardin gene showed 100% homology with the Assemblage AI. This work suggests for the first time in Italy that sheep carry a Giardia genotype, which can be a potential public health hazard.