重庆城区中小学生月经初潮及首次遗精与父母生育年龄的相关性

  目的  探索北京市中小学生青春发育时相与父母生育年龄的关系，为进一步了解儿童青少年青春发育提供参考。  方法  于2012年10月，采取分层整群抽样方法对3 113名来自北京市房山区16所中小学校的学生进行问卷调查，采用多分类多因素logistic回归模型分析父母生育年龄对中小学生青春发育时相的影响。  结果  男生青春发育时相提前和延迟检出率分别为14.73 %和9.61 %，女生为12.84 %和10.99 %。调整了超重肥胖、低出生体重和家庭经济水平等因素后，多因素分析结果表明，相较于父亲生育年龄20岁～组（对照组），父亲生育年龄 ≥ 35岁组的男生青春发育提前风险升高2.36倍（95 % CI = 1.05～5.32），父亲生育年龄30岁～组的男生青春发育延迟风险降低为对照组的0.42倍（95 % CI = 0.18～0.97）。对女生而言，调整了超重肥胖、低出生体重和家庭经济水平等因素后，多因素分析表明，父亲生育年龄30岁～组和 ≥ 35岁组、母亲生育年龄30岁～组和 ≥ 35岁组的女生青春发育提前风险分别升高1.87倍（95 % CI = 1.10～3.19）、5.20倍（95 % CI = 2.68～10.08）和2.21倍（95 % CI = 1.32～3.70）、4.14倍（95 % CI = 1.79～9.53）；进一步调整了父母亲生育年龄后，父亲生育年龄 ≥ 35岁组的女生青春发育提前风险是20岁～组的4.18倍（95 % CI = 1.73～10.13）；未发现父母亲生育年龄和女生青春发育时相延迟存在相关性。  结论  父亲生育年龄大是男生青春发育时相提前和延迟的独立危险因素，也是女生青春发育时相提前的独立危险因素，应鼓励和倡导适龄生育。

A Lancet Commission on 70 years of women's reproductive,maternal, newborn,child, and adolescent health in China

  Objective  To explore the relationship between puberty timing and parental age at childbirth among primary and secondary students and in Beijing, and to provide a reference for further comprehending puberty development of children and adolescents.   Methods  Using a self-designed questionnaire and the Puberty Development Scale (PDS), we conducted a survey among 3 441 students recruited with stratified cluster sampling at 16 primary and secondary schools in urban and rural regions of Fangshan district of Beijing during October 2012. Multivariate logistic analysis was adopted to investigate the relationship between parental age at childbirth and puberty timing among the students.   Results  Among 3 113 students (1 602 boys and 1 511 girls) with complete information, the prevalence of early and delayed puberty were 14.73% and 9.61% in the boys; but in the girls, the prevalences were 12.84% and 10.99% respectively. After adjusting confounding factors such as overweight and obesity, low birth weight, and family economic condition and taking the students with the parental ages of 20 – 24 years as the controls, multivariate logistic analyses showed following results: (1) the boys with the paternal age of ≥ 35 years at childbirth were at an increased risk of early puberty (odds ratio [OR] = 2.36, 95% confidence interval [95% CI]: 1.05 – 5.32); (2) the boys with the paternal age of 30 – 34 years at childbirth were at a decreased risk of delayed puberty (OR = 0.42, 95% CI: 0.18 – 0.97); (3) the girl students with elder parental age at childbirth were at an increased risk of early puberty (for paternal age of 30 – 34 years: OR = 1.87, 95% CI: 1.10 – 3.19; for paternal age of ≥ 35 years: OR = 5.20, 95% CI: 2.68 – 10.08; for maternal age of 30 – 34 years: OR = 2.21, 95% CI: 1.32 – 3.70; for maternal age of ≥ 35 years: OR = 4.14, 95% CI: 1.79 – 9.53); and (4) after further adjusting paternal/maternal age at childbirth, the girl students with the paternal age of ≥ 35 years were at an increased risk of early puberty (OR = 4.18, 95% CI: 1.73 – 10.13). No significant correlation was observed between delayed puberty timing and paternal/maternal age at childbirth in girl students.   Conclusion  The elder paternal age at childbirth is an independent risk factor for earlier or later puberty timing among primary and secondary boy students, and the elder paternal age is also an independent risk factor for earlier puberty among primary and secondary girl students. The results suggest that childbearing at an appropriate age should be promoted in young couples.