EARLY-CHILDHOOD DETERMINANTS OF AGE AT MENARCHE IN RURAL GUATEMALA

The influence of early childhood determinants on age at menarche was i nvestigated in a sample of Guatemalan women who participated as childr en in a nutrition intervention study conducted from 1969 to 1977. Age at menarche was retrospectively estimated in 1991 and 1992. Mean age a t menarche was 13.7 (+/-1.3) years. Data on linear growth, diarrhea an d respiratory illnesses, and energy intake from supplementation as wel l as home sources were available between birth and 7 years of age. Soc ioeconomic status (SES) data were collected in 1975. Four hundred and ninety-seven women who had reached menarche by 1992 were grouped into three categories of stunting based on their height-for-age z-scores (n one, >-2.0; moderate, -2.0 SD to -3.0 SD; severe, <-3.0 SD relative to National Center for Health Statistics reference data) at 3 years of a ge. About 78% of the sample was moderately or severely stunted at 3 ye ars of age. The group that was severely stunted in childhood reached m enarche at 14.1 +/- 1.4 years, significantly later than those who were moderately stunted (13.7 +/- 1.2 years) or not stunted (13.5 +/- 1.3 years). Using multiple linear regression methods, stunting was a signi ficant predictor of age at menarche. Average energy intake (kcal/d) fr om home diet was associated with earlier menarche independent of presc hool growth status. Percent time ill with diarrhea was positively asso ciated with age at menarche. When the effects of diet, supplement, per cent time ill with diarrhea and respiratory illnesses, and SES were ta ken into account, the independent influence of stunting on age at mena rche persisted and remained significant. (C) 1996 Wiley-Liss, Inc.