Effects of maternal passive smoking during pregnancy and girls’ overweight/obesity on the age at menarche in urban areas of Guangzhou

Abstract

Objective To investigate the effect of maternal passive smoking during pregnancy and girls’ overweight /obesity on the age at menarche (AAM), and to provide a reference for improving healthy development of children and adolescents.

Methods Based on the school entrance physical examination in 2016, a cross-section study was conducted by convenient sampling method, in a total of 2 722 students of 7th grade, from 26 middle schools in urban areas of Guangzhou. Multivariate logistic regression model was used to investigate the relationship between maternal passive smoking during pregnancy and girls’ overweight /obesity and AAM. A four-way decomposition method was used to explore the mediated effect of girls’ overweight/obesity on the relationship between maternal passive smoking during pregnancy and AAM.

Results The proportion of girls who had menstruate was 90.82%(2 472/2 722). The median AAM was 12.00 years old, with an early menarche rate of 34.91%(863/2 472). Compared with girls whose mother hadn’ t passive smoking during pregnancy, the risk of early AAM in girls with mother passive smoking during pregnancy ≤ 3 days/week increased by 32% ( OR = 1.32, 95% CI = 1.06-1.65), the risk in girls with maternal passive smoking during pregnancy>3 days/week increased by 58% ( OR = 1. 58, 95% CI = 1.21 - 2.07). Multivariate Logistic regression analysis showed that, overweight or obesity girls had a 77% higher risk of early AAM than non-overweight/obesity girls ( OR = 1.77, 95% CI = 1.36-2.31). The four-way decomposition analysis showed 79.60% of early AAM risk could be accounted by maternal passive smoking during pregnancy ( P<0.01).

Conclusion Girls’ overweight/obesity and maternal passive smoking during pregnancy were associated with early menarche. The effect on daughters’ age at menarche is mainly in a direct effect manner of maternal passive smoking during pregnancy.

Abstract

【摘要】 目的 探讨母亲孕期被动吸烟及女生超重肥胖对女生月经初潮年龄 (age at menarche, AAM) 的影响, 为促 进儿童青少年健康成长提供参考。 方法 基于 2016 年中学新生体检工作, 采用方便抽样法对广州市城区 26 所中学的 2 722 名初一女生进行问卷调查和体格检查。应用 Logistic 回归模型分析女生超重肥胖、母亲孕期被动吸烟与女生 AAM 的 关系, 采用四向分解法探讨女生超重肥胖在母亲孕期被动吸烟对女生 AAM 提前中的中介效应。 结果 女生月经来潮率为 90.82% (2 472/2 722)。月经初潮中位年龄为 12.00 岁, 初潮提前率为 34.91% (863/2 472)。与母亲孕期无被动吸烟的女 生相比, 母亲孕期被动吸烟 ≤ 3 d/周的女生 AAM 提前的风险增加32% ( OR _调整 =1.32, 95% CI =1.06〜1.65), 母亲孕期被动 吸烟> 3 d/周的女生 AAM 提前的风险增加58% ( OR _调整 =1.58, 95% CI = 1.21〜2.07)。超重肥胖女生 AAM 提前的风险比非 超重肥胖的女生增加 77% ( OR _调整=1.77, 95% CI = 1.36〜2.31)。四向分解结果显示, 母亲孕期被动吸烟导致女儿 AAM 提前 的风险中, 79.60% 归因于母亲孕期被动吸烟的直接效应 ( P<0.01)。 结论 女生超重肥胖和母亲孕期被动吸烟与女生 AAM 提前关联。母亲孕期被动吸烟对女生 AAM 提前的影响方式可能以直接作用为主。