Loading ...

TOPLINE:

Adverse childhood experiences (ACEs) were associated with substantially higher risk for earlier menarche and pubertal onset in girls while showing no significant effects on boys’ pubertal timing. Sexual abuse, caregiver incarceration, and emotional neglect emerged as the individual ACEs most strongly linked to early menarche.

METHODOLOGY:

• A retrospective cohort study analyzed data from 52,573 pediatric members (47.3% female participants, 52.7% male participants) of Kaiser Permanente – Northern California in Pleasanton, California, an integrated healthcare system serving approximately 4.5 million members.
• Researchers evaluated total ACE scores using caregiver- and self-reported Pediatric ACEs and Related Life Events Screener across well-child visits, categorizing scores into 0, 1-3, 4-6, or 7-10 ACEs.
• Outcome measures included age at menarche from well-child questionnaires and physician-assessed sexual maturity ratings for pubertal onset, with girls reporting menstruation at age 11 years or younger classified as early.
• Analysis included logistic regression for menarche timing and Weibull regression models for pubertal onset, adjusting for maternal age, parity, education level, and child’s race/ethnicity.

TAKEAWAY:

• Girls with 4-6 ACEs showed significantly higher risk for earlier thelarche (hazard ratio [HR], 1.09; 95% CI, 1.00-1.19), whereas those with 7-10 ACEs demonstrated even stronger associations (HR, 1.38; 95% CI, 1.16-1.65).
• Sexual abuse and caregiver incarceration were most strongly associated with early thelarche (HR, 1.18; 95% CI, 1.05-1.32 and HR, 1.15; 95% CI, 1.05-1.26, respectively) and pubarche (HR, 1.17; 95% CI, 1.05-1.32 and HR, 1.19; 95% CI, 1.08-1.31, respectively).
• According to the authors, boys’ pubertal timing appeared less sensitive to early-life adversity, with no significant associations observed between ACEs and male pubertal development.
• The cohort demonstrated diverse representation with 33.2% White, 7.6% Black, 24.9% Hispanic, and 25.3% Asian and Pacific Islander participants.

IN PRACTICE:

“From an evolutionary perspective, threats to mortality, such as adversity, may accelerate puberty in girls to enhance reproductive chances, whereas earlier puberty in boys may reduce reproductive success due to smaller stature,” wrote the authors of the study. They added, “Some clinicians are already using ACE screenings to identify children at risk for mental health conditions and other health issues. While early puberty may not be the primary focus of interventions, awareness of its potential associations with adversity could help clinicians take a more holistic approach in supporting affected youth.”

SOURCE:

The study was led by Ai Kubo, PhD, MPH, Division of Research, Kaiser Permanente – Northern California. It was published online in Journal of Adolescent Health.

LIMITATIONS:

According to the authors, the study was limited by data collected for nonresearch purposes and the lack of information regarding the timing and frequency of ACEs.

DISCLOSURES:

The research was funded by the National Institute of Child Health and Human Development RO1HD098220. The authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.