ความแตกต่างของอายุที่เริ่มเข้าสู่วัยสาวและอายุที่เริ่มมีประจำเดือนระหว่างเด็กนักเรียนหญิงในเขตเมือง และ นอกเขตเมือง จังหวัดฉะเชิงเทรา

Abstract

Precocious puberty is related to adult short stature and multiple psychosocial problems. Several studiesduring  the past two decades demonstrated that the onset of puberty and the menarche have been decreasing worldwide. However there are only few studies addressing the age of pubertal development in Thai girls. Objectives:To compare the onset of puberty and menarche in school-aged girls between urban and rural areas and identify the possible  factors related to the early onset of puberty and menarche. Study design: Cross-sectional analytic study Materials  and methods: Nine hundreds and nine school-aged girls at an urban school and 409 school-aged girls attwo rural schools in Chachoengsao province were enrolled to the study. Weight and height were measured and bodymass  index was calculated. Breast Tanner staging was evaluated by female Pediatric Endocrinologists. Questionnaires on relating factors were collected for analyses. Results: The onset of puberty and menarche in the urban school-aged girls were significantly earlier than the rural ones 9 .76 ± 1 .2 vs 1 0.67 ± 1 .3 and 11.87 ± 1 .2 vs. 12.53± 1.2 years respectively (Ps<0.01). Using stepwise multiple linear regression analysis BMI Z-score and living inurban areas had the significant effect on the early onset of puberty (R=0.465 and R=0.529 respectively Ps<0.001) andage at menarche (R=0.432 and R=0.393 respectively Ps<0.001). Conclusions: Thai urban school-aged girl in Chachoengsao  province had significantly earlier onset of puberty and menarche than the rural ones. These findingswere  related to obesity and living in the urban area. Further study is needed to identify whether early pubertal development and obesity will affect final adult height.