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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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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.
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.