Age at menarche and pregnancy-related pelvic pain

• Published in: The journal of obstetrics and gynaecology research 2013-05, Vol.39 (5), p.1037-1044
• Main Authors: Kirkeby, Mette J., Biering, Karin, Olsen, Jørn, Juhl, Mette, Nohr, Ellen A.
• Format: Article
• Language: English
• Subjects: Adult; Aging; Case-Control Studies; Cohort Studies; Denmark - epidemiology; early menarche; Female; Humans; Menarche; pelvic pain; Pelvic Pain - epidemiology; Pelvic Pain - physiopathology; Pregnancy; Pregnancy Complications - epidemiology; Pregnancy Complications - physiopathology; Risk Factors; Severity of Illness Index; Young Adult
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.12008

Aim Menarcheal age is a predictor of several complications related to pregnancy and diseases later in life. We aimed to study if menarcheal age is a risk factor for pregnancy‐related pelvic pain. Material and Methods A nested case–control study was conducted within the Danish National Birth Cohort, a cohort of pregnant women, recruited during 1996–2002, and their children. In the second trimester of pregnancy the women provided information about age at menarche and potential confounders. Selection of cases (n = 2227) was based on self‐reported pelvic pain during pregnancy from an interview done 6 months post‐partum. The controls (n = 2588) were randomly selected among women who did not report pelvic pain. We used logistic regression analysis to calculate odds ratios (OR) for pregnancy‐related pelvic pain according to age at menarche. Results In the cohort, 18.5% of all pregnant women reported pregnancy‐related pelvic pain. Compared to women who were 12–14 years old at menarche, the adjusted OR for overall pelvic pain were 1.4 (95% confidence interval [CI] 1.1–1.7) in women 11 years or younger and 0.8 (95%CI 0.6–0.9) in women 15 years or older. The corresponding adjusted OR for severe pelvic pain were 1.6 (95%CI 1.3–2.0) and 0.7 (95%CI 0.6–0.9). When age was analyzed as a continuous variable, the odds for overall and severe pelvic pain decreased with 14% and 16%, respectively, for each increasing year. Conclusions The risk of pregnancy‐related pelvic pain decreased with increasing menarcheal age in an ‘exposure‐response’ pattern. A low menarcheal age is a risk indicator and may be a risk factor for pregnancy‐related pelvic pain.