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International Journal of Pediatrics
Volume 2010, Article ID 329261, 8 pages
Research Article

Pubertal Pathways in Girls Enrolled in a Contemporary British Cohort

1Epidemiology Department, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
2Environmental Epidemiology and Population Health Research Group, Research Centre of the University of Montreal Hospital Centre (CRCHUM), 3875 rue Saint-Urbain 3e étage, Bureau 314 Montréal, QC, Canada H2W 1V1
3National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341, USA
4Department of Social Medicine, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK
5Department of Community Based Medicine, Centre for Child and Adolescent Health, University of Bristol, Barley House, Oakfield Grove, Clifton, Bristol BS8 2BN, UK

Received 13 January 2010; Accepted 5 May 2010

Academic Editor: Thomas C. Hulsey

Copyright © 2010 Krista Yorita Christensen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Data from the Avon Longitudinal Study of Parents and Children were used to describe initiation of secondary sexual characteristic development of girls. Tanner stages of breast and pubic hair and menarche status were self-reported via mailed questionnaires, administered from ages 8–14. Initiation pathway was categorized as breast [thelarche] or pubic hair [pubarche] development alone, or synchronous. Average ages at beginning breast and pubic hair development were estimated using survival analysis. Factors associated with initiation pathway were assessed using logistic regression. Among the 3938 participants, the median ages at beginning breast and pubic hair development were 10.19 (95% CI: 10.14–10.24) and 10.95 (95% CI: 10.90–11.00) years. Synchronous initiation was the most commonly reported pathway (46.3%), followed by thelarche (42.1%). Girls in the pubarche pathway were less likely to be obese or overweight at age 8 or have an overweight or obese mother. Girls in the thelarche pathway were less likely to be of nonwhite race or be the third born or later child.