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Knight JA , Kehm RD , Schwartz L , Frost CJ , Chung WK , Colonna S , Keegan THM , Goldberg M , Houghton LC , Hanna D , Glendon G , Daly MB , Buys SS , Andrulis IL , John EM , Bradbury AR , Terry MB
Pre-Pubertal Internalizing Symptoms and Timing of Puberty Onset in Girls
Am J Epidemiol. 2021 Feb 1;190(3) :431-438
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Abstract
Stressful environments have been associated with earlier menarche. We hypothesized that anxiety, and possibly other internalizing symptoms, are also associated with earlier puberty in girls. The LEGACY Girls Study (2011-2016) includes 1040 girls aged 6 to 13 years at recruitment with growth and development assessed every 6 months. Pre-pubertal maternal reports of daughter's internalizing symptoms were available for breast onset (N=447), pubic hair onset (N=456), and menarche (N=681). Using Cox Proportional Hazard Regression, we estimated prospective hazard ratios (HRs) and 95% confidence intervals (CIs) for the relationship between one standard deviation of the percentiles of pre-pubertal anxiety, depression, and somatization symptoms and the timing of each pubertal outcome. Multivariable models included age, race/ethnicity, study center, maternal education, body mass index percentile, and breast cancer family history. Additional models included maternal self-reported anxiety. One standard deviation increase of maternally-reported anxiety in girls at baseline was associated with earlier subsequent onset of breast (HR 1.22, 95% CI 1.09-1.36) and pubic hair (HR 1.15, 95% CI 1.01-1.30) development, but not menarche (HR 0.94, 95% CI 0.83-1.07). The association of anxiety with earlier breast development persisted after adjustment for maternal anxiety. Increased anxiety in young girls may indicate risk for earlier pubertal onset.
Notes
1476-6256 Knight, Julia A Kehm, Rebecca D Schwartz, Lisa Frost, Caren J Chung, Wendy K Colonna, Sarah Keegan, Theresa H M Goldberg, Mandy Houghton, Lauren C Hanna, Danielle Glendon, Gord Daly, Mary B Buys, Saundra S Andrulis, Irene L John, Esther M Bradbury, Angela R Terry, Mary Beth Journal Article United States Am J Epidemiol. 2020 Oct 15:kwaa223. doi: 10.1093/aje/kwaa223.