Association Between Age At Menarche And Risk Of Pregnancy Complications

Part 1 Association between age at menarche and risk of gestational diabetes mellitus Objective:Gestational diabetes mellitus has adverse short-and long-term influence on both maternal and neonatal health.Early menarche has been reported to be associated with an increased risk of type 2 diabetes,but little is known about the association of age at menarche with risk of gestational diabetes mellitus.The aim of this study was to examine the association between age at menarche and risk of gestational diabetes mellitus among Chinese women.Methods:Data were from the Wuhan Healthy Baby Cohort study.For the present analysis,the women excluded were those with a history of diabetes(n=6),and no available information on age at menarche(n=163),leaving 11142 pregnant women for inclusion in the final analysis.Data were collected from face-to-face interviews,maternity health handbook or medical records.Self-reported age at menarche were categorized into five age groups(?11,12,13,14,and?15 years).Information on gestational diabetes mellitus was obtained from medical records.All analyses were performed using SAS version 9.4 software.Numerical variables were compared using t test,and categorical variables were compared using?2test.Logistic regression models were used to estimate the odds ratio(OR)and 95%confidence interval(CI)for the association between age at menarche and gestational diabetes mellitus.Covariates for the adjusted models included age at delivery,level of education,employment status,alcohol consumption before pregnancy,smoking before pregnancy,passive smoking during pregnancy,physical activity during pregnancy,parity,hypertensive disorders of pregnancy,and pre-pregnancy BMI.Subgroup analyses were stratified by age at delivery(<28 or?28 years),pre-pregnancy BMI(<24kg/m~2 or?24kg/m~2),level of education(high school or below,college or above),parity(primiparous or multiparous),and hypertensive disorders of pregnancy(yes or no).The tests for interaction across subgroup were performed using Wald test.Results:Of the 11142 pregnant women,905(8.1%)were diagnosed with gestational diabetes mellitus.The mean age at menarche was 13.1±1.2 years,and the mean age at delivery was 28.2±3.7 years.The adjusted prevalence of gestational diabetes mellitus for menarche at ages?11,12,13,14,and?15 years were 10.7%(95%CI:8.3%~13.0%),8.4%(95%CI:7.3%~9.4%),7.6%(95%CI:6.8%~8.4%),7.5%(95%CI:6.5%~8.6%),and 9.1%(95%CI:7.5%~10.7%),respectively.Logistic regression analysis showed that compared with menarche at age 13 years,early menarche(?11 years)was associated with an increased risk of gestational diabetes mellitus after adjusting for potential confounders(OR=1.47,95%CI:1.10~1.95).Subgroup analyses showed that the association between age at menarche and risk of gestational diabetes mellitus was more pronounced among women<28 years of age than women?28 years of age(OR=2.15,95%CI:1.30~3.56 vs.OR=1.25,95%CI:0.89~1.77;P for interaction=0.044).Conclusions:Our findings suggested that early menarche was a risk factor for gestational diabetes mellitus.This findings could help obstetricians and midwives to identify women at higher risk of gestational diabetes mellitus.These women would benefit from early preventative strategiesPart 2 Association between age at menarche and risk of hypertensive disorders of pregnancyObjective: Hypertensive disorders of pregnancy is one of the leading cause of maternal mortality.Early menarche has been reported to be associated with hypertension in non-pregnant women with controversial finding,but evidence of its association with hypertensive disorders of pregnancy is lacking.The aim of this study was to examine the association of age at menarche with risk of hypertensive disorders of pregnancy among Chinese women.Methods: Data were from the Wuhan Healthy Baby Cohort study.For the present analysis,the women excluded were those with no available information on age at menarche(n=163),leaving 11148 pregnant women for inclusion in the final analysis.Data were collected from face-to-face interviews,maternity health handbook or medical records.Self-reported age at menarche were categorized into five age groups(?11,12,13,14,and ?15 years).Information on hypertensive disorders of pregnancy was obtained from medical records.All analyses were performed using SAS version 9.4 software.Numerical variables were compared using t test,and categorical variables were compared using ?2 test.Logistic regression models were used to estimate the odds ratio(OR)and 95% confidence interval(CI)for the association between age at menarche and hypertensive disorders of pregnancy.Covariates for the adjusted models included age at delivery,level of education,employment status,alcohol consumption before pregnancy,smoking before pregnancy,passive smoking during pregnancy,physical activity during pregnancy,parity,gestational diabetes mellitus,and pre-pregnancy BMI.Subgroup analyses were stratified by age at delivery(<28 or ?28 years),pre-pregnancy BMI(<24kg/m2 or ?24kg/m2),level of education(high school or below,college or above),parity(primiparous or multiparous),and gestational diabetes mellitus(yes or no).The tests for interaction across subgroup were performed using Wald test.Results: Of the 11148 pregnant women,355(3.2%)were diagnosed with hypertensive disorders of pregnancy.The mean age at menarche was 13.1±1.2 years,and the mean age at delivery was 28.2±3.7 years.The adjusted prevalence of hypertensive disorders of pregnancy for menarche at ages ?11,12,13,14,and ?15 years were 3.1%(95%CI:1.8%~4.3%),3.0%(95%CI:2.4%~3.6%),3.3%(95%CI:2.8% ~ 3.9%),3.4%(95%CI : 2.7% ~ 4.2%),and 2.4%(95%CI : 1.5% ~ 3.3%),respectively.Logistic regression analysis showed that compared with menarche at age13 years,early menarche(?11 years)was not associated with risk of hypertensive disorders of pregnancy after adjusting for potential confounders(OR=0.92,95%CI: 0.58~1.47).Subgroup analyses showed that there were on interactions between age at menarche and age at delivery,pre-pregnancy BMI,level of education,parity,or gestational diabetes mellitus on risk of hypertensive disorders of pregnancyConclusions: The finding of our study suggested that early menarche was not associated with risk of hypertensive disorders of pregnancy.However,due to the existence of research limitations,and further population studies are needed to clarify the relationship between them.