Perinatal & Pediatric
Exploring Patterns in Age at Menarche: The Effect of Are Deprivation Index Through a Lifecourse Perspective in the Bogalusa Heart Study Eunsun Gill* Eunsun Gill Katherine P. Theall Dohyeong Kim Soo Jung Kang Courtney J Thomas Jessica A Broach Lydia A. Bazzano Camilo Fernandez Emily W. Harville
Introduction: Early and late menarche are related to adverse health outcomes. Area Deprivation Index (ADI), a measure of neighborhood socioeconomic conditions, may influence age at menarche (AAM), but its lifecourse evidence remains limited. We explored the influence of evolving ADI on AAM and moderating effect of obesity in the Bogalusa Heart Study (BHS).
Methods: A secondary longitudinal study (1974─2004) was conducted among 1,821 girls from the BHS, with up to six follow-up visits. ADI, based on 16 block-group census variables via factor analysis, was measured repeatedly and divided into quintiles (Q; Q1=least deprived; Q5=most). AAM was self-reported in year and month. Weibull accelerated failure time model analyzed the association between ADI and AAM, adjusting for race, exam year, maternal and paternal education, maternal smoking, systolic blood pressure, glucose, total cholesterol, and obesity with multiple imputation.
Results: Data from 1,821 girls (55.7% White; 44.3% Black; AAM: 7.1─16.8 years; median follow-up=4.2 years) showed a J-shaped association between ADI and AAM, with lower and higher deprivation linked to earlier menarche compared to the middle. Compared to girls in Q4, those in Q2 (Time ratio [TR]=0.97, 95% CI: 0.95─0.98), as well as those in Q1 and Q5 (TR=0.98; 95% CI: 0.97─0.99; TR=0.98; 95% CI: 0.96─1.00) exhibited earlier menarche, while the Q3 had a smaller effect (TR=0.99; 95% CI: 0.96─1.00, overall p=0.004). BMI modified the association, with significant effects among normal weight (Q2 vs. Q4: TR=0.97) and overweight (Q1 vs. Q4: TR=0.94), but not among obese (Q5 vs. Q4: TR=1.06; p for interaction: 0.045)
Conclusions: Both low and high neighborhood deprivation were associated with earlier menarche, a reproductive milestone linked to cardiometabolic and reproductive health risks. Environmental deprivation may shape long-term health trajectories via its influence on AAM.
Keywords: area deprivation index; menarche; neighborhood deprivation
