Effect of maternal previous pregnancy on children’s pubertal development: an 8-year pubertal cohort
Authors: Zhang Qin , Zhang Jie , Feng Xinyi , Wu Di , Chen Zixuan , Li Yan , Liu Qin 
Published: February 2025

Abstract

STUDY QUESTION
Does the maternal pregnancy history affect the course of their offspring’s pubertal development?

SUMMARY ANSWER
Maternal pregnancy history, particularly adverse outcomes, significantly influences the timing of menarche and the tempo of breast development in girls.

WHAT IS KNOWN ALREADY
Preliminary evidence indicates that parity may affect the onset of puberty, mainly as reflected by changes in the timing of pubic and axillary hair development.

STUDY DESIGN, SIZE, DURATION
This 8-year cohort, conducted semi-annually, was recruited from four primary schools. The average follow-up duration was 6.09 years (range: 2–8 years).

PARTICIPANTS/MATERIALS, SETTING, METHODS
The study cohort comprised 1390 children, including 710 girls and 680 boys, with age ranges of 6.58–19.26 years and 5.81–19.28 years, respectively, over an 8-year follow-up period. The primary exposure was whether the mother has a history of pregnancy prior to the birth of the child, including childbearing, miscarriage, and other adverse pregnancy outcomes. Pubertal milestones as assessed by a professional, including breast and genital development, were modeled using logistic regression, and the age of menarche was documented for girls. Associations between maternal pregnancy history and pubertal progression in both genders were analyzed using generalized linear regression models.

MAIN RESULTS AND THE ROLE OF CHANCE
Girls from non-first pregnancies experienced a delayed age at menarche by 0.22 years (95% CI: 0.05, 0.38) and a more rapid tempo of breast development (0.06; 95% CI: 0.01, 0.11) compared to those from first pregnancies, particularly among girls with a history of maternal adverse pregnancy outcomes. The effect of maternal pregnancy history on pubertal development was less pronounced in boys than in girls.

LIMITATIONS, REASONS FOR CAUTION
The sample was relatively small, and the cohort also lacks sufficient data due to missing data points and some study participants still maturing. While model fitting aids in describing incomplete pubertal development, the logistic growth mixed-effects model’s assumptions about growth curves may not fully reflect reality.

WIDER IMPLICATIONS OF THE FINDINGS
Maternal pregnancy history, particularly adverse outcomes, can markedly influence pubertal progression in girls. Previous studies have shown that the timing and tempo of pubertal development impact adolescent psychological and behavioral health, and have implications for reproductive health and diseases in adulthood. Optimal pregnancy planning by mothers is essential for enhancing the well-being of both mother and offspring.

STUDY FUNDING/COMPETING INTEREST(S)
This work was supported by Chongqing Natural Science Foundation project (CSTB2023NSCQ-MSX0133), National Natural Science Foundation of China (81973067), National Youth Science Fund Project (81502825), and Program for Youth Innovation in Future Medicine, Chongqing Medical University (W0054). This study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of Chongqing Medical University (Reference Number: 2023003). Informed consent was obtained from all participants and their guardians involved in the study. The authors declared that they have no conflicts of interest to disclose.

TRIAL REGISTRATION NUMBER
N/A.