Age at menarche and risk of adverse obstetric outcomes during the first childbirth in Japan: The Japan Environment and Children's Study

Aim Age at menarche is used as a risk indicator of gestational diabetes mellitus, preterm birth, and fetal growth. However, little is known regarding the age impact on obstetric outcomes among nulliparous women. This study investigated whether menarche age was correlated with obstetric outcomes among nulliparous women. Methods We analyzed the data obtained for 37 645 singleton pregnancies between 2011 and 2014 in the Japan Environment and Children's Study. Age at menarche was categorized into the <= 9-, 10-, 11-, 12-, 13-, 14-, and >= 15-year-old groups (n = 363, 3155, 8390, 11 164, 6713, 5446, and 2414, respectively). We calculated the relative risk for cases of preterm birth <37 weeks, low birthweight <2500 g, small for gestational age, early and late-onset hypertension disorders of pregnancy, and early- and late-diagnosed (diagnosed < or >= 24 weeks) gestational diabetes mellitus using a reference of 12 years at menarche. Results Women with an age at menarche <= 9 years showed an increased incidence of developing early-diagnosed gestational diabetes mellitus (relative risk: 2.42; 95% confidence interval: 1.05-5.60). A high body mass index before pregnancy increased the risk of developing gestational diabetes mellitus. Conclusions Age at menarche helped in assessing the risk of early-diagnosed gestational diabetes mellitus among nulliparous women. Future studies are needed to clarify the underlying mechanisms. This study is the first to use data from the largest prospective birth cohort study of Japan and to investigate the relationship between menarche age and obstetric outcomes among nulliparous women.