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Early puberty in 11-year-old girls: Millennium Cohort Study findings
  1. Yvonne Kelly1,
  2. Afshin Zilanawala1,
  3. Amanda Sacker1,
  4. Robert Hiatt2,
  5. Russell Viner3
  1. 1Department of Epidemiology and Public Health, University College London, London, UK
  2. 2Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
  3. 3Institute of Child Health, University College London, London, UK
  1. Correspondence to Professor Yvonne Kelly, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK, y.kelly{at}


Objective Early puberty in girls is linked to some adverse outcomes in adolescence and mid-life. We address two research questions: (1) Are socioeconomic circumstances and ethnicity associated with early onset puberty? (2) Are adiposity and/or psychosocial stress associated with observed associations?

Design Longitudinal data on 5839 girls from the UK Millennium Cohort Study were used to estimate associations between ethnicity, family income, adiposity and psychosocial stress with a marker of puberty.

Main outcome measure Reported menstruation at age 11 years.

Results All quoted ORs are statistically significant. Girls in the poorest income quintile were twice as likely (OR=2.1), and the second poorest quintile nearly twice as likely (OR=1.9) to have begun menstruation compared with girls in the richest income quintile. Estimates were roughly halved on adjustment for Body Mass Index and markers of psychosocial stress (poorest, OR=1.5; second poorest, OR=1.5). Indian girls were over 3 times as likely compared with whites to have started menstruation (OR=3.5) and statistical adjustments did not attenuate estimates. The raised odds of menstruation for Pakistani (OR=1.9), Bangladeshi (OR=3.3) and black African (OR=3.0) girls were attenuated to varying extents, from about a third to a half, on adjustment for income and adiposity.

Conclusions In contemporary UK, excess adiposity and psychosocial stress were associated with social inequalities in early puberty, while material disadvantage and adiposity were linked to ethnic inequalities in early puberty among girls.

  • inequalities
  • ethnicity
  • socioeconomic
  • menarche

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  • Contributors All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. YK conceptualised and designed the study, drafted the initial manuscript and approved the final manuscript as submitted. AZ carried out the analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted. AS, RH and RV critically reviewed the manuscript and approved the final manuscript as submitted. YK will act as guarantor for the manuscript. YK affirms that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

  • Funding This work was supported by a grant from the Economic and Social Research Council RES-596-28-0001.

  • Competing interests YK, AZ and AS had financial support from the Economic and Social Research Council (RES-596-28-0001) for the submitted work.

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

  • Data sharing statement Data are available on request from the authors.

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