title: Early menarche and childhood adversities in a nationally representative sample.
abstract: BACKGROUND
  Epidemiological evidence suggests that early menarche, defined as onset of menses at age 11 or earlier, has increased in prevalence in recent birth cohorts and is associated with multiple poor medical and mental health outcomes in adulthood. There is evidence that childhood adversities occurring prior to menarche contribute to early menarche.
  
  
  METHODS
  Data collected in face-to-face interviews with a nationally representative sample of women age 18 and over (N = 3288), as part of the National Comorbidity Survey-Replication, were analyzed. Associations between pre-menarchal childhood adversities and menarche at age 11 or earlier were estimated in discrete time survival models with statistical adjustment for age at interview, ethnicity, and body mass index. Adversities investigated included physical abuse, sexual abuse, neglect, biological father absence from the home, other parent loss, parent mental illness, parent substance abuse, parent criminality, inter-parental violence, serious physical illness in childhood, and family economic adversity.
  
  
  RESULTS
  Mean age at menarche varied across decadal birth cohorts (χ(2)₍₄₎ = 21.41, p < .001) ranging from a high of 12.9 years in the oldest cohort (age 59 or older at the time of interview) to a low of 12.4 in the second youngest cohort (age 28-37). Childhood adversities were also more common in younger than older cohorts. Of the 11 childhood adversities, 5 were associated with menarche at age 11 or earlier, with OR of 1.3 or greater. Each of these five adversities is associated with a 26% increase in the odds of early menarche (OR = 1.26, 95% CI 1.14-1.39). The relationship between childhood sexual abuse and early menarche was sustained after adjustment for co-occurring adversities. (OR = 1.77, 95% CI 1.21-2.6).
  
  
  CONCLUSIONS
  Evidence from this study is consistent with hypothesized physiological effects of early childhood family environment on endocrine development. Childhood sexual abuse is the adversity most strongly associated with early menarche. However, because of the complex way that childhood adversities cluster within families, the more generalized influence of highly dysfunctional family environments cannot be ruled out.
authors.affiliation: University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-4108, USA.
authors.forename: Kimberly L
authors.initials: KL
authors.lastname: Henrichs
authors.affiliation: University of Pittsburgh School of Medicine, 3420 Fifth Avenue, Pittsburgh, PA 15213, USA ; Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, 3420 Fifth Avenue, Pittsburgh, PA 15213, USA.
authors.forename: Heather L
authors.initials: HL
authors.lastname: McCauley
authors.affiliation: University of Pittsburgh School of Medicine, 3420 Fifth Avenue, Pittsburgh, PA 15213, USA ; Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, 3420 Fifth Avenue, Pittsburgh, PA 15213, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Miller
authors.affiliation: University of California Davis, 2516 Stockton Blvd, Sacramento, CA 95817, USA.
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Styne
authors.affiliation: University of California Davis, 1616 DaVinci Court, Davis, CA 95618, USA.
authors.forename: Naomi
authors.initials: N
authors.lastname: Saito
authors.affiliation: RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Breslau
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