Perinatal & Pediatric
Sustained melatonin supplement use and the timing of pubertal onset in a diverse U.S. population. Ekaterina Sadikova* Ekaterina Sadikova Divyangana Rakesh Henning Tiemeier
Melatonin supplement use (MSU) is prevalent (12-20%) among U.S. youth, despite a debate about its effects on the timing of pubertal onset. Animal studies show that MSU can suppress gonadotropin releasing hormone secretion – the trigger of the pubertal cascade. The effect of MSU on pubertal onset is important to understand given adverse mental and physical health consequences of early puberty.
Using data from 5,933 prepubescent participants of the Adolescent Brain Cognitive Development study (baseline age 9-10 years, 28.6% female, 61.6% non-Hispanic white), we tracked MSU across 4 annual study visits. Pubertal onset was assessed using the parent-rated Pubertal Development Scale. All analyses were stratified by sex assigned at birth. Kaplan-Meier curves demonstrated unadjusted associations with any MSU. The parametric g-formula assessed the effect of sustained MSU on the timing of pubertal onset by accounting for confounding by constant and time-varying socioeconomic, parent, and child characteristics – including child sleep disturbances. An exploratory analysis looked at effect modification by race/ethnicity.
Unadjusted 4-year cumulative risk of pubertal onset was lower among melatonin users in both sex strata (log rank test p=0.09 for females and p=0.08 for males). The g-formula analysis showed no effect of sustained MSU on pubertal onset in either sex stratum (RR=1.00, 95%CI 0.98-1.01 among females and RR=1.04, 95%CI 0.97-1.09 among males). However, we found evidence of modification of MSU’s effect by race/ethnicity among females (p=0.02 for interaction), with sustained MSU predicting modest delays in pubertal onset among minoritized females (RR=0.90, 95%CI 0.67-1.01).
Our analysis is the first to assess the causal effect of sustained MSU on pubertal timing in a diverse population. While no average effects were evident, more data is needed to confirm if MSU has potential to narrow racial/ethnic disparities in pubertal timing among children assigned female at birth.
