Article Text
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.
- review
- cross-sectional survey
- public health
- child health
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Footnotes
Handling editor Seye Abimbola
Contributors TL was the principal investigator on the project, conceptualised the study, designed the analysis, conducted the analysis and wrote the first draft of the paper. LB conducted the literature review and the analysis and contributed to the write-up of the paper.
Funding This study was funded by STICERD, LSE.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available in a public, open access repository. All data are available from the Demographic and Health Surveys website upon registration.
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