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Age at menarche and the risk of operative delivery.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Chong, Hsu Phern 
Frøen, J Frederik 
Liquet, Benoit 
Charnock-Jones, D Stephen 

Abstract

OBJECTIVES: We sought to evaluate the impact of later menarche on the risk of operative delivery. POPULATION: We studied 38,069 eligible women (first labors at term with a singleton infant in a cephalic presentation) from the Norwegian Mothers and Child Cohort Study. The main exposures were the age at menarche and the duration of the interval between menarche and the first birth. METHODS: Poisson's regression with a robust variance estimator. MAIN OUTCOME MEASURES: Operative delivery, defined as emergency cesarean or assisted vaginal delivery (ventouse extraction or forceps). RESULTS: A 5 year increase in age at menarche was associated with a reduced risk of operative delivery (risk ratio [RR] 0.84, 95%CI 0.78, 0.89; p < .001). Adjustment for the age at first birth slightly strengthened the association (RR 0.79, 95%CI 0.74, 0.84; p < .001). However, the association was lost following adjustment for the menarche to birth interval (RR 0.99, 95%CI 0.93, 1.06; p = .81). A 5 years increase in menarche to birth interval was associated with an increased risk of operative delivery (RR 1.26, 95%CI 1.23, 1.28; p < .001). This was not materially affected by adjustment for an extensive series of maternal characteristics (RR 1.23, 95%CI 1.20, 1.25; p < .001). CONCLUSIONS: Later menarche reduces the risk of an operative first birth through shortening the menarche to birth interval. This observation is consistent with the hypothesis that the pattern and/or duration of prepregnancy exposure of the uterus to estrogen and progesterone contributes to uterine aging.

Description

Keywords

Menarche, cesarean, maternal age, operative vaginal delivery, Adult, Age Factors, Cesarean Section, Delivery, Obstetric, Extraction, Obstetrical, Female, Humans, Infant, Newborn, Male, Menarche, Norway, Obstetric Labor Complications, Obstetrical Forceps, Pregnancy, Risk Factors, Term Birth, Vacuum Extraction, Obstetrical, Young Adult

Journal Title

J Matern Fetal Neonatal Med

Conference Name

Journal ISSN

1476-7058
1476-4954

Volume Title

32

Publisher

Informa UK Limited
Sponsorship
Cambridge University Hospitals NHS Foundation Trust (CUH) (RG52380)