Prenatal factors affecting age at menarche

Abstract

OBJECTIVES: Age at menarche (AAM) is one of the most significant indicators of female sexual maturation. Early AAM may be associated with cancers of the reproductive organs, obesity, diabetes type 2, cardiovascular diseases, infertility and psychological disorders in later life. There are data that some prenatal conditions may contribute to AAM, however, no consensus view on this problem exists. We have systematically reviewed the available literature in order to identify these factors and their relative significance for AAM. METHOD: Using various combinations of keywords, we searched MEDLINE and Google Scholar databases for the data published from 1980 till December 2012. In total 134 articles were retrieved, and 65 of them contained information relevant to our study. RESULTS: The following prenatal factors have been reported as associated with AAM: mother ’ s AAM, weight gain during pregnancy, preeclampsia, birth size, prematurity, environmental hazards exposure during pregnancy. Birth weight and exposure to estrogen-like endocrine disruptors seem to have the most significant effect on AAM. Low birth weight, especially due to intrauterine growth restriction, can lower AAM by 0.5 to 0.8 year through development of insulin resistance and further childhood obesity. Intrauterine exposure to endocrine disruptors can lead to premature puberty and, as a result, early AAM up to one year before the expected age. The data about the effect of maternal smoking on the daughter’s AAM are still inconsistent. Smoking during pregnancy normally leads to in utero growth retardation but the recent studies reported a delay in menarcheal onset despite expected acceleration. Association between AAM and pregnancy complications, alcohol and caffeine prenatal exposure seems are controversial and need further studying. CONCLUSIONS: Better understanding of the association between some prenatal events and early AAM might help to minimise their influence on female pubertal growth.