The study of pubertal stage and age of menarche in girls in Isfahan province, Iran

Abstract Background The onset age of pubertal changes varies widely among girls and has undergone changes over time around the world. This study aimed to determine the age of onset of puberty in healthy Iranian girls living in Isfahan province. Methods This cross- sectional study was conducted among...

Full description

Saved in:
Bibliographic Details
Main Authors: Nafiseh Mozafarian, Mahin Hashemipour, Mohammad Reza Maracy, Masoumeh Pourrajab, Razieh Omidi, Roya Kelishadi
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Pediatrics
Subjects:
Online Access:https://doi.org/10.1186/s12887-024-05212-0
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832571315171622912
author Nafiseh Mozafarian
Mahin Hashemipour
Mohammad Reza Maracy
Masoumeh Pourrajab
Razieh Omidi
Roya Kelishadi
author_facet Nafiseh Mozafarian
Mahin Hashemipour
Mohammad Reza Maracy
Masoumeh Pourrajab
Razieh Omidi
Roya Kelishadi
author_sort Nafiseh Mozafarian
collection DOAJ
description Abstract Background The onset age of pubertal changes varies widely among girls and has undergone changes over time around the world. This study aimed to determine the age of onset of puberty in healthy Iranian girls living in Isfahan province. Methods This cross- sectional study was conducted among 13,886 students aged 6–18 years. They were selected by multistage random cluster sampling from urban and rural areas of Isfahan province of Iran. Pubertal stage was determined according the 5-level Tanner stages proposed by Marshall and Tanner. Trained physicians determined the breast development through both visual inspection and palpation, in addition, mothers assessed their daughter’s pubic hair growth using Tanner’s Sexual Maturation Scale (SMS) by comparison to standard pictures. The data were analyzed by the status quo method. Probit regression analysis was used to evaluate the median age of onset for each characteristic including menarche, breast and pubic hair. Results A total of 13,886 healthy girls with mean age (SD) of 11.97 (2.9) were studied. Overall 6968 (50.2%) girls experienced menstruation with a median (95%CI) age of 12.05(11.88–12.21) years at its onset. The median age for onset of breast development was 9.89 (95% CI: 9.77 − 10.02) years and for onset of pubic hair development was 10.14 (95% CI: 9.88– 10.39) years. The 3rd percentile for breast stage 2 (B2) and pubic hair stage 2 (PH2) was 6.85 and 6.75 years, respectively, and the 97th percentile for B2 and PH2 was 12.94and 13.54 years, respectively. Conclusion According to our findings, the onset of puberty before 6.85 years should be considered as precocious puberty for Iranian girls. Our study indicated the secular trend toward earlier menarche in girls. Nationally representative surveys and longitudinal studies are necessary to determine the exact age of puberty for future international comparisons.
format Article
id doaj-art-90c375ac452b4a12aabbfed57da50842
institution Kabale University
issn 1471-2431
language English
publishDate 2025-01-01
publisher BMC
record_format Article
series BMC Pediatrics
spelling doaj-art-90c375ac452b4a12aabbfed57da508422025-02-02T12:42:49ZengBMCBMC Pediatrics1471-24312025-01-012511910.1186/s12887-024-05212-0The study of pubertal stage and age of menarche in girls in Isfahan province, IranNafiseh Mozafarian0Mahin Hashemipour1Mohammad Reza Maracy2Masoumeh Pourrajab3Razieh Omidi4Roya Kelishadi5Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical SciencesMetabolic Liver Disease Research Center, Isfahan University of Medical SciencesDepartment of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical SciencesIsfahan Provincial Education and Training OrganizationHealth Center of Isfahan Province, Isfahan University of Medical SciencesChild Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical SciencesAbstract Background The onset age of pubertal changes varies widely among girls and has undergone changes over time around the world. This study aimed to determine the age of onset of puberty in healthy Iranian girls living in Isfahan province. Methods This cross- sectional study was conducted among 13,886 students aged 6–18 years. They were selected by multistage random cluster sampling from urban and rural areas of Isfahan province of Iran. Pubertal stage was determined according the 5-level Tanner stages proposed by Marshall and Tanner. Trained physicians determined the breast development through both visual inspection and palpation, in addition, mothers assessed their daughter’s pubic hair growth using Tanner’s Sexual Maturation Scale (SMS) by comparison to standard pictures. The data were analyzed by the status quo method. Probit regression analysis was used to evaluate the median age of onset for each characteristic including menarche, breast and pubic hair. Results A total of 13,886 healthy girls with mean age (SD) of 11.97 (2.9) were studied. Overall 6968 (50.2%) girls experienced menstruation with a median (95%CI) age of 12.05(11.88–12.21) years at its onset. The median age for onset of breast development was 9.89 (95% CI: 9.77 − 10.02) years and for onset of pubic hair development was 10.14 (95% CI: 9.88– 10.39) years. The 3rd percentile for breast stage 2 (B2) and pubic hair stage 2 (PH2) was 6.85 and 6.75 years, respectively, and the 97th percentile for B2 and PH2 was 12.94and 13.54 years, respectively. Conclusion According to our findings, the onset of puberty before 6.85 years should be considered as precocious puberty for Iranian girls. Our study indicated the secular trend toward earlier menarche in girls. Nationally representative surveys and longitudinal studies are necessary to determine the exact age of puberty for future international comparisons.https://doi.org/10.1186/s12887-024-05212-0PubertyMenarcheThelarchePubarcheChildren and adolescent
spellingShingle Nafiseh Mozafarian
Mahin Hashemipour
Mohammad Reza Maracy
Masoumeh Pourrajab
Razieh Omidi
Roya Kelishadi
The study of pubertal stage and age of menarche in girls in Isfahan province, Iran
BMC Pediatrics
Puberty
Menarche
Thelarche
Pubarche
Children and adolescent
title The study of pubertal stage and age of menarche in girls in Isfahan province, Iran
title_full The study of pubertal stage and age of menarche in girls in Isfahan province, Iran
title_fullStr The study of pubertal stage and age of menarche in girls in Isfahan province, Iran
title_full_unstemmed The study of pubertal stage and age of menarche in girls in Isfahan province, Iran
title_short The study of pubertal stage and age of menarche in girls in Isfahan province, Iran
title_sort study of pubertal stage and age of menarche in girls in isfahan province iran
topic Puberty
Menarche
Thelarche
Pubarche
Children and adolescent
url https://doi.org/10.1186/s12887-024-05212-0
work_keys_str_mv AT nafisehmozafarian thestudyofpubertalstageandageofmenarcheingirlsinisfahanprovinceiran
AT mahinhashemipour thestudyofpubertalstageandageofmenarcheingirlsinisfahanprovinceiran
AT mohammadrezamaracy thestudyofpubertalstageandageofmenarcheingirlsinisfahanprovinceiran
AT masoumehpourrajab thestudyofpubertalstageandageofmenarcheingirlsinisfahanprovinceiran
AT raziehomidi thestudyofpubertalstageandageofmenarcheingirlsinisfahanprovinceiran
AT royakelishadi thestudyofpubertalstageandageofmenarcheingirlsinisfahanprovinceiran
AT nafisehmozafarian studyofpubertalstageandageofmenarcheingirlsinisfahanprovinceiran
AT mahinhashemipour studyofpubertalstageandageofmenarcheingirlsinisfahanprovinceiran
AT mohammadrezamaracy studyofpubertalstageandageofmenarcheingirlsinisfahanprovinceiran
AT masoumehpourrajab studyofpubertalstageandageofmenarcheingirlsinisfahanprovinceiran
AT raziehomidi studyofpubertalstageandageofmenarcheingirlsinisfahanprovinceiran
AT royakelishadi studyofpubertalstageandageofmenarcheingirlsinisfahanprovinceiran