Timing of menarche has largely been studied in the context of a secular trend. However, since mortality and fertility rates are fundamental demographic factors linked to a population's developmental and reproductive characteristics, we expect that the timing of menarche, a precondition to reproduction, is also associated with these vital rates. We conduct an analysis of 89 countries and 21 demographic, socioeconomic, nutritional, and educational variables selected for their known influence on menarche. Model results predict that a country's fertility and adult female mortality rates are significant predictors of mean age at menarche, while other covariates are not. Specifically, menarche is delayed in countries with high mortality and high fertility, which may be proxies for assessing overall environmental quality. We emphasize that, for a comprehensive understanding of the timing of menarche, it is critical to take into account both individual- and population-level influences.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6472797 | PMC |
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215462 | PLOS |
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