title: Fetal environment and early age at natural menopause in a British birth cohort study.
abstract: BACKGROUND
  Early life development may influence the timing of natural menopause through association with size of the initial follicle pool or early follicular loss. This study examines the relationships of birthweight, gestational age and birthweight standardized by gestational age with early menopause in the 1958 British birth cohort study.
  
  
  METHODS
  Study participants were over 2900 women with data on birthweight, gestational age (obtained at birth), menopausal status at age 44-45 years and potential confounding factors. Logistic regression was used to study relationships of birthweight, gestational age and birthweight standardized by gestational age with post-menopausal status by 44-45 years, with and without adjustments for confounding factors.
  
  
  RESULTS
  There was a U-shaped association between birthweight and menopausal status at 44-45 years: women at either extremes of birthweight (<2.5 and >or=4.0 kg) had increased odds of post-menopausal status compared with those weighing 3.0-3.49 kg [odds ratio (OR) = 1.91, 95% confidence interval (CI) 1.08, 3.38; 1.81, 95% CI 1.11, 2.97, respectively]. Women with higher birthweight standardized by gestational age (which indicates faster fetal growth rate) also had increased odds of being post-menopausal by 44-45 years (OR for fastest quarter versus second fastest quarter = 1.80; 95% CI 1.16, 2.81). These associations persisted after adjustment for socioeconomic position at birth, adult smoking status and use of oral contraceptives.
  
  
  CONCLUSIONS
  These findings suggest that variations in fetal environment may be associated with the timing of menopause. Given that extremes of birthweight and higher birthweight standardized by gestational age were associated with earlier age at menopause, mechanisms related to these characteristics that also regulate ovarian function should be investigated further.
authors.affiliation: Group Health Research Institute, 1730 Minor Aveue, Suite 1600, Seattle, WA 98101, USA. tom.s@ghc.org
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Tom
authors.forename: Rachel
authors.initials: R
authors.lastname: Cooper
authors.forename: Diana
authors.initials: D
authors.lastname: Kuh
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hardy
authors.forename: Chris
authors.initials: C
authors.lastname: Power
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D008593:Menopause / Q000502:physiology*; D008594:Menopause, Premature / Q000502:physiology*; D008875:Middle Aged; D017698:Postmenopause; D012907:Smoking; D012959:Socioeconomic Factors