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Cited by 47Hypothalamic control of reproductive hormonesBirth, Development, and HealthHuman Health and Disease

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Analysis of Early-Life Growth and Age at Pubertal Onset in US Children

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Aris, Izzuddin M., Perng, Wei, Dabelea, Dana, Ganiban, Jody M., Liu, Chang, Marceau, Kristine, Robertson, Olivia C., Hockett, Christine W., Mihalopoulos, Nicole L., Kong, Xiangrong, Herting, Megan M., O’Shea, T. Michael, Jensen, Elizabeth T., Hivert, Marie-France, Oken, Emily, Program Collaborators for Environmental Influences on Child Health Outcomes, Alshawabkeh, Akram, Aschner, Judy, Blair, Clancy, Camargo, Carlos, Deoni, Sean, Duarte, Cristiane, Dunlop, Anne, Elliott, Amy, Ferrara, Assiamira, Gern, James, Breton, Carrie, Hertz-Picciotto, Irva, Hipwell, Alison, Karagas, Margaret, Karr, Catherine, Lester, Barry, Leve, Leslie, Lewis, Johnnye, Weiss, Scott, McEvoy, Cynthia, Newschaffer, Craig, O’Connor, Thomas, Kerver, Jean, Herbstman, Julie, Schantz, Susan, Stanford, Joseph, Trasande, Leonardo, Wright, Rosalind·2022·JAMA Network Open
DOI 10.1001/jamanetworkopen.2021.46873PMC PMC8817204
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Abstract

Importance: Earlier pubertal onset may be associated with an increased risk of chronic diseases. However, the extent to which growth in the first 5 years of life-an important developmental life stage that lays the foundation for later health outcomes-is associated with pubertal onset remains understudied. Objective: To assess whether changes in weight, length or height, and body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) during the first 5 years of life are associated with earlier pubertal onset. Design, Setting, and Participants: This cohort study used data from 36 cohorts participating in the Environmental Influences on Child Health Outcomes program from January 1, 1986, to December 31, 2015. Participant inclusion required at least 1 anthropometric measure in the first 5 years of life and at least 1 measure of pubertal onset. Data were analyzed from January 1 to June 30, 2021. Exposures: Standardized velocities of weight, length or height, and BMI gain in early infancy (0-0.5 years), late infancy (0.5-2 years), and early childhood (2-5 years). Main Outcomes and Measures: Markers of pubertal onset for boys and girls, including age at peak height velocity (APHV), time to puberty score greater than 1, time to Tanner pubic hair stage greater than 1, and time to menarche. Multivariable regression models were used to estimate mean differences in APHV by growth periods. Results: Of 7495 children included in the study, 3772 (50.3%) were girls, 4505 (60.1%) were White individuals, and 6307 (84.1%) were born during or after the year 2000. Girls had a younger APHV (10.8 vs 12.9 years) than boys. In boys, faster weight gain (per 1-SD increase) in early infancy (β, -0.08 years; 95% CI, -0.10 to -0.06), late infancy (β, -0.10 years; 95% CI, -0.12 to -0.08), and early childhood (β, -0.07 years; 95% CI, -0.08 to -0.05) was associated with younger APHV after adjusting for the child's birth year, race, and Hispanic ethnicity as well as maternal age at delivery; educational level during pregnancy; annual household income during pregnancy; prenatal cigarette smoking; whether the mother was nulliparous; whether the mother had gestational diabetes, hypertension, or preeclampsia; mode of delivery; prepregnancy BMI; gestational weight gain; and gestational age at delivery. Similar associations were observed for length or height and BMI gains during the same age periods. In girls, faster gains (per 1-SD increase) in weight (β, -0.03 years; 95% CI, -0.05 to -0.01) and height (β, -0.02 years; 95% CI, -0.04 to 0.00) in early childhood were associated with younger APHV. Faster BMI gain in late infancy was associated with earlier time to menarche, whereas faster BMI gain in early childhood was associated with earlier time to Tanner pubic hair stage greater than 1. Conclusions and Relevance: This cohort study found that faster gains in weight, length or height, or BMI in early life were associated with earlier pubertal onset. The results suggest that children who experience faster early growth should be monitored closely for earlier onset of puberty and referred as appropriate for supportive services.

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  • The average age of pubertal onset is reported at 10.8 years in females versus 12.9 years in males.

    “The average age of pubertal onset is reported at 10.8 years in females versus 12.9 years in males (Aris et al., 2022).”

    From The relationship between psychological readiness to return to sport and kinesiophobia in teens and young adults after anterior cruciate ligament reconstruction (2025) · cites this paper as Aris et al., 2022

    The Results report 10.8 years for girls and 12.9 years for boys, but those figures are ages at peak height velocity (APHV), not directly measured ages of pubertal onset. The Methods (Primary Outcome) describe APHV as a marker of pubertal timing, so the claim preserves the numbers and sex comparison while treating a marker as the onset age itself. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

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Metadata

Authors
Aris, I. M., Perng, W., Dabelea, D., Ganiban, J. M., Liu, C., Marceau, K., Robertson, O. C., Hockett, C. W., Mihalopoulos, N. L., Kong, X., Herting, M. M., O’Shea, T. M., Jensen, E. T., Hivert, M.-F., Oken, E., Outcomes, P. C. F. E. I. O. C. H., Alshawabkeh, A., Aschner, J., Blair, C., Camargo, C., Deoni, S., Duarte, C., Dunlop, A., Elliott, A., Ferrara, A., Gern, J., Breton, C., Hertz-Picciotto, I., Hipwell, A., Karagas, M., Karr, C., Lester, B., Leve, L., Lewis, J., Weiss, S., McEvoy, C., Newschaffer, C., O’Connor, T., Kerver, J., Herbstman, J., Schantz, S., Stanford, J., Trasande, L., & Wright, R.
Affiliations
  • Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, Massachusetts
  • Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
  • Department of Psychological and Brain Sciences, George Washington University, Washington, DC
  • Department of Human Development and Family Studies, Purdue University, West Lafayette, Indiana
  • Avera Research Institute, Sioux Falls, South Dakota
  • Department of Pediatrics, The University of Utah, Salt Lake City
  • Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
  • Department of Population and Public Health Sciences, University of Southern California, Los Angeles
  • Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill
  • Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
  • for the Program Collaborators for Environmental Influences on Child Health Outcomes
Venue
JAMA Network Open
Publisher
American Medical Association (AMA)
Published
2022-02-04
Volume
5
Issue
2
Pages
e2146873
ISSN
2574-3805 (ISSN-L)
DOI
10.1001/jamanetworkopen.2021.46873
PMC
PMC8817204
OpenAlex
W4210568555
Cited by
47
References
4
Citations by year
2026: 9 · 2025: 13 · 2024: 12 · 2023: 9 · 2022: 4
FWCI
5.99
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JAMA Network Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
  • UNC Libraries
Funders
  • National Institutes of Health (UG3OD023249, UH3OD023271, UH3OD023286, UG3OD023253, UG3OD023290, KL2TR002534, UH3OD023320, UG3OD035516, UL1TR002538, UG3OD023271, UH3OD023249, UH3OD023289, UH3OD023389, UH3OD023253, UH3OD023288, UH3OD023275, U2COD023375, UH3OD023279, UH3OD035532, U24OD023382, UH3OD023282, UH3OD035513, UH3OD023348, UH3OD023248, UH3OD023290, UH3OD023337, UH3OD023342)
  • Wake Forest School of Medicine
  • NIH Office of the Director (UH3OD023348, UH3 OD023337, UH3-OD023248, UH3OD023279, UH3OD023282, UH3 OD023289, UH3OD023286, UH3OD023253, UH3OD023288, UH3OD023320, UH3OD023342, UH3 OD023290, U2COD023375, UH3OD023275, U24OD023382)
  • National Eye Institute
  • National Center for Advancing Translational Sciences
  • Colorado Clinical and Translational Sciences Institute (KL2‐TR002534)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Human Health and Disease
Keywords
puberty onset, early life growth, infant weight gain, body mass index, peak height velocity, menarche, sex differences, birth year, childhood obesity risk, developmental origins of health and disease, anthropometry, 2000s generation
MeSH terms
Adolescent, Anthropometry, Child, Child Development, Female, Humans, Male, Puberty, United States, Age of Onset

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