Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 173, Issue 12, Pages 1440-1452Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwr028
Keywords
child; cohort studies; infant; infection; puberty
Categories
Funding
- Health and Welfare Bureau, Government of the Special Administrative Region, China [216106]
- Health and Health Services Research Fund [03040771]
- Research Fund for the Control of Infectious Diseases in Hong Kong [04050172, 06060592]
- Government of the Hong Kong Special Administrative Region
- University Research Committee Strategic Research Theme of Public Health, University of Hong Kong
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As economic development increases, puberty occurs at younger ages, and this could contribute to an increase in the incidence of cardiovascular diseases and hormone-related cancers. The factors that determine pubertal timing are poorly understood. The growth axis that is active during puberty is active in the first 6 months of life and interacts with the immune system. The authors examined whether prior infections, proxied by number of hospital admissions for infections at different ages, were associated with age at pubertal onset (Tanner stage II) using interval-censored regression in the Children of 1997 cohort, which is a population-representative Chinese birth cohort (n = 7,527). Mediation by growth was also examined. Girls, but not boys, who were hospitalized for infections at least twice in the first 6 months of life experienced pubertal onset about 8 months later (mean = 10.3 years, time ratio = 1.08, 95% confidence interval: 1.04, 1.12) than did those without such hospitalizations (mean 9.6 years) after adjustment for infant characteristics and socioeconomic position (sex interaction: P = 0.02). There were no such associations for infections at 6 months to < 8 years of age. Growth did not mediate the association. Early infectious morbidity in girls may be associated with later puberty, perhaps via suppression of the gonadotropic axis. The lowering of the number of infections in early life that accompanies economic development could be an additional factor that contributes to earlier puberty.
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