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Original research
Early physical maturation and subjective health complaints in adolescent girls: a pooled cross-sectional analysis
  1. Qiguo Lian1,
  2. Ruili Li2,
  3. Frank J Elgar3,
  4. Qiru Su4
  1. 1 NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
  2. 2 Children Health and Development Department, Capital Institute of Pediatrics, Beijing, China
  3. 3 Institute for Health and Social Policy, McGill University, Montreal, Québec, Canada
  4. 4 Department of Clinical Research, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
  1. Correspondence to Dr Qiru Su, Shenzhen Children's Hospital, Shenzhen, Guangdong, China; suqiru_sz{at}163.com

Abstract

Background Although adolescents are generally healthy, subjective health complaints (SHC) are common in this age group, especially in adolescent girls. We explored the association between early menarche and the frequency of psychosomatic symptoms and how this association varies between countries.

Methods Our sample included 298 000 adolescent girls from 2002, 2006, 2010 and 2014 cycles of the Health Behaviour in School-aged Children (HBSC) study in 41 European and North American countries. School surveys measured the frequency of eight psychosomatic symptoms in the past 6 months. Early maturation was defined as self-reported age at menarche below 11 years. Using logistic regression, we estimated adjusted ORs (aORs) and 95% CIsof experiencing each psychosomatic symptom at least more than once a week and experiencing two or more symptoms at least more than once a week.

Results Early menarche occurred in 4.73% of the sample and was positively related to headache, stomachache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties in sleeping, feeling dizzy and two or more of these symptoms, respectively (all p values<0.001). The interactions between early menarche and survey circle were non-significant. Changing the age criterion to 12 years did not affect the results. The associations between early menarche and psychosomatic symptoms were robust across the HBSC-participating counties with two age criteria.

Conclusions Early menarche positively relates to various psychosomatic symptoms in European and North American adolescent girls. Our findings suggest that early-maturing girls may need early supportive interventions.

  • accidents
  • health promotion
  • low back pain
  • public health
  • social sciences

Data availability statement

Data are available in a public, open access repository. Data for the HBSC 2002, 2006, 2010 and 2014 cycles can be freely accessed on HBSC Data Management Centre (https://www.uib.no/en/hbscdata/113290/open-access), and data for the country wealth can be freely accessed on World Bank Open Data (https://data.worldbank.org/indicator/NY.GDP.PCAP.PP.CD) and StatBank Greenland (https://bank.stat.gl/pxweb/en/Greenland/).

https://doi.org/10.1136/jech-2022-219547

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    Data availability statement

    Data are available in a public, open access repository. Data for the HBSC 2002, 2006, 2010 and 2014 cycles can be freely accessed on HBSC Data Management Centre (https://www.uib.no/en/hbscdata/113290/open-access), and data for the country wealth can be freely accessed on World Bank Open Data (https://data.worldbank.org/indicator/NY.GDP.PCAP.PP.CD) and StatBank Greenland (https://bank.stat.gl/pxweb/en/Greenland/).

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    Footnotes

    • Contributors QS conceptualised and designed the study, interpreted the results, revised the manuscript, and is responsible for the overall content as guarantor. QL analysed the data and drafted the manuscript. RL performed the literature review and revised the manuscript critically. FE assisted with the analysis and revised the manuscript for important intellectual content. All authors reviewed and approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

    • Funding This study was supported by Guangdong Medical Science and Technology funding (B2021039) and Shenzhen Children's Hospital 2020 funding (ynkt2020-zz21). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.