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Infection and pubertal timing: a systematic review

Published online by Cambridge University Press:  13 July 2016

J. A. McDonald*
Affiliation:
Mailman School of Public Health, Columbia University, New York, NY, USA
S. M. Eng
Affiliation:
Mailman School of Public Health, Columbia University, New York, NY, USA
O. O. Dina
Affiliation:
Mailman School of Public Health, Columbia University, New York, NY, USA
C. M. Schooling
Affiliation:
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People’s Republic of China China and School of Public Health, The City University of New York and Hunter College, New York, NY, USA
M. B. Terry
Affiliation:
Mailman School of Public Health, Columbia University, New York, NY, USA Herbert Irving Comprehensive Cancer Center, New York, NY, USA
*
*Address for correspondence: J. A. McDonald, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, New York, NY 10032, USA. (Email [email protected])

Abstract

The decline in age of pubertal timing has serious public health implications ranging from psychosocial adjustment problems to a possible increase in reproductive cancers. One biologically plausible explanation for the decline is a decrease in exposures to infections. To systematically review studies that assess the role of infection in pubertal timing, Medline, Web of Science and EMBASE were systematically searched and retrieved studies were reviewed for eligibility. Eligible studies examined the association between infections, including microbial exposures, and physical pubertal characteristics (breast, genitalia and pubic hair development) or age at menarche. We excluded studies that were published in a language other than English, focused on precocious puberty, were case studies, and/or included youth with autoimmune diseases. We report on study design, population characteristics, measurement of infection and puberty and the main effects of infection on pubertal development. Based on our search terms we identified 1372 unique articles, of which only 15 human and five animal studies met our eligibility criteria. Not all studies examined all outcomes. Infection was associated with later breast development (4/4 human studies), with less consistent evidence for genitalia and pubic hair development. Seven studies assessed age at menarche with inconsistent findings (three supporting later, four no association). We conclude that a small but consistent literature supports that infection is associated with later breast development; the evidence for other pubertal events and age at menarche is less clear. Where fewer childhood infections coincide with the rise in incidence of hormone-related cancers.

Type
Review
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2016 

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