Accuracy of pubertal Tanner staging self-reporting.
ABSTRACT Previous studies examining the reliability of self-reported Tanner stages have given conflicting results. We report on the reliability of self-reported Tanner stages in lean healthy children.
Self-reported Tanner staging of 240 children (130 girls, 110 boys) were compared to the ratings of a pediatric endocrinologist who was unaware of the children's self-assessments. The correlation between the two approaches was analyzed using kappa statistics.
40% (kappa coeffcient = 0.49, p <0.001) and 23% (kappa coefficient = 0.68, p <0.001) of the girls rated their breast and pubic Tanner stage incorrectly, respectively; 39% of the boys (kappa coefficient = 0.49, p <0.001) rated their pubic stage incorrectly. The age of the children who self-rated correctly and incorrectly was not different; no independent predictors for correct Tanner staging self-assessment were found.
The results of this analysis suggest that self-rated Tanner pubertal staging is not influenced by age and is not a reliable method of assessing Tanner stage.
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ABSTRACT: Is sugar-sweetened beverage (SSB) consumption associated with age at menarche? More frequent SSB consumption was associated with earlier menarche in a population of US girls. SSB consumption is associated with metabolic changes that could potentially impact menarcheal timing, but direct associations with age at menarche have yet to be investigated. The Growing up Today Study, a prospective cohort study of 16 875 children of Nurses' Health Study II participants residing in all 50 US states. This analysis followed 5583 girls, aged 9-14 years and premenarcheal at baseline, between 1996 and 2001. During 10 555 person-years of follow-up, 94% (n = 5227) of girls reported their age at menarche, and 3% (n = 159) remained premenarcheal in 2001; 4% (n = 197) of eligible girls were censored, primarily for missing age at menarche. Cumulative updated SSB consumption (composed of non-carbonated fruit drinks, sugar-sweetened soda and iced tea) was calculated using annual Youth/Adolescent Food Frequency Questionnaires from 1996 to 1998. Age at menarche was self-reported annually. The association between SSB consumption and age at menarche was assessed using Cox proportional hazards regression. More frequent SSB consumption predicted earlier menarche. At any given age between 9 and 18.5 years, premenarcheal girls who reported consuming >1.5 servings of SSBs per day were, on average, 24% more likely [95% confidence interval (CI): 13, 36%; P-trend: <0.001] to attain menarche in the next month relative to girls consuming ≤2 servings of SSBs weekly, adjusting for potential confounders including height, but not BMI (considered an intermediate). Correspondingly, girls consuming >1.5 SSBs daily had an estimated 2.7-month earlier menarche (95% CI: -4.1, -1.3 months) relative to those consuming ≤2 SSBs weekly. The frequency of non-carbonated fruit drink (P-trend: 0.03) and sugar-sweetened soda (P-trend: 0.001), but not iced tea (P-trend: 0.49), consumption also predicted earlier menarche. The effect of SSB consumption on age at menarche was observed in every tertile of baseline BMI. Diet soda and fruit juice consumption were not associated with age at menarche. Although we adjusted for a variety of suspected confounders, residual confounding is possible. We did not measure SSB consumption during early childhood, which may be an important window of exposure. More frequent SSB consumption may predict earlier menarche through mechanisms other than increased BMI. Our findings provide further support for public health efforts to reduce SSB consumption. The Growing up Today Study is supported by grant R03 CA 106238. J.L.C. was supported by the Breast Cancer Research Foundation; Training Grant T32ES007069 in Environmental Epidemiology from the National Institute of Environmental Health Sciences, National Institutes of Health; and Training Grant T32HD060454 in Reproductive, Perinatal and Pediatric Epidemiology from the National Institute of Child Health and Human Development, National Institutes of Health. A.L.F. is supported by the American Cancer Society, Research Scholar Grant in Cancer Control. K.B.M. was supported in part by the National Cancer Institute at the National Institutes of Health (Public Health Service grants R01CA158313 and R03CA170952). There are no conflicts of interest to declare. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
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ABSTRACT: Pubertal status is related to childhood growth and independently associated with health outcomes such as lung function, blood pressure and mental health (1). However, self-assessment of pubertal status is difficult in young children as relevant questions may either be too difficult for young children, especially boys, to answer reliably or perceived to be culturally inappropriate (1-5). This is especially true for overweight children (6). The Size and Lung function In Children (SLIC) study was designed to explore ethnic differences in lung function and body physique in a multi-ethnic population of London schoolchildren (7). As part of this study, we collected both self-reports and parental reports of pubertal status in children aged eight to 11 years, both to investigate the feasibility of assessing the attainment of secondary sex characteristics, as a proxy for pubertal status in this population, and to explore any ethnic differences in rates of pubertal attainment.This article is protected by copyright. All rights reserved.Acta Paediatrica 11/2014; DOI:10.1111/apa.12850 · 1.84 Impact Factor
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ABSTRACT: Abstract Aim: To assess the reliability of pubertal self-assessment of Thai adolescents. Subjects: Some 927 girls and 997 boys, aged 8-18 years, from nine schools in Hat-Yai municipality. Methods: The adolescents evaluated their pubertal status after being shown a line drawing of the five Tanner stages with a short description. Girls assessed their breast and pubic hair development, and boys assessed their pubic hair development. The pubertal self-assessments were compared to pubertal assessments made by a pediatrician who examined the children after their self-assessment. Kappa coefficient and percent agreement were used for statistical analysis. Results: The percent agreement of breast and pubic hair development between the girl's self-assessments and the assessments by the pediatrician were 60.8% and 78%, respectively. Kappa coefficient for breast assessment was 0.50 (95% confidence interval, CI 0.47-0.53) and for pubic hair 0.68 (95% CI 0.65-0.72). Nearly 30% of girls aged younger than 10 years overestimated their breast development status while 45% of girls aged over 14 years underestimated their breast development (p<0.001). For boys, the percent agreement of pubic hair development between the adolescents and the pediatrician was 76.4%, with a weighted kappa coefficient of 0.68 (95% CI 0.65-0.72). Conclusion: Pubertal self-assessment using line drawings with a short description can be used as a reliable method to assess pubic hair maturation in boys and girls, but can be used with less reliability to assess the breast maturation in young girls.Journal of pediatric endocrinology & metabolism: JPEM 09/2014; 28(3-4). DOI:10.1515/jpem-2014-0053 · 0.71 Impact Factor