ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: Pregnancy Hypertens. 2019 Jan;15:134–140.

This observational cohort study highlights the negative association between age at menarche and blood pressure in pregnancy, and the probable relationship with BMI and insulin resistance.

Age at menarche (AAM) is influenced by genetic and environmental determinants (1). Given that some of the genetic variants associated with AAM are also associated with body mass index (BMI) it is perhaps not surprising that AAM is also linked to some BMI-related pathological conditions (2, 3).

This study analyzed data from 438 mothers from the Cambridge Baby Growth Study. Carlo Acerini who devoted much of his career to this study sadly passed away in May 2019. AAM was recalled using a questionnaire completed by the women. Blood pressure was measured four times during pregnancy (at mean 11.8; 31.4; 37 and 38.8 weeks).

The study showed a negative association between AAM and the four arterial blood pressure measurements, especially with systolic blood pressure. This association was attenuated when adjusted for either pre-pregnancy BMI or insulin resistance, suggesting a potential mechanism involving increased adiposity and insulin resistance. There was no significant association between AAM and hypertensive disorders of pregnancy.

Despite some limitations highlighted by the authors (studied women were not entirely representative of the population, AAM was self-reported, variation in the numbers of participants in the different models), the study suggests that blood pressure in pregnancy is related to AAM and that adiposity and insulin resistance may be involved in mediating these associations. The findings highlight the role of early AAM in a particular female life course trajectory leading to poor cardiometabolic health.

References: 1. Couch FJ, et al. 2014 Parent-of-origin-specific allelic associations among 106 genomic loci for age at menarche. Nature 514: 92–97.

2. Luijken J, Van Der Schouw YT, Mensink D, Onland-Moret NC. 2017 Association between age at menarche and cardiovascular disease: A systematic review on risk and potential mechanisms. Maturitas 104:96–116.

3. Janghorbani M, Mansourian M, Hosseini E. 2014 Systematic review and meta-analysis of age at menarche and risk of type 2 diabetes. Acta Diabetol. 51: 519–528.

4. Petry CJ, Ong KK, Hughes IA, Acerini CI, Dunger DB. 2018 The association between age at menarche and later risk of gestational diabetes is mediated by insulin resistance. Act. Diabetol. 55: 853–59.