The relationship between social determinants of health and girls' age at menarche based on the world health organization model: path analysis

Saeideh Nasiri; Mahrokh Dolatian; Fahimeh Ramezani Tehrani; Hamid Alavi Majd; Azam Bagheri

doi:10.1016/j.heliyon.2022.e10794

The relationship between social determinants of health and girls' age at menarche based on the world health organization model: path analysis

Heliyon. 2022 Sep 29;8(10):e10794. doi: 10.1016/j.heliyon.2022.e10794. eCollection 2022 Oct.

Authors

Saeideh Nasiri¹, Mahrokh Dolatian², Fahimeh Ramezani Tehrani³, Hamid Alavi Majd⁴, Azam Bagheri¹

Affiliations

¹ Department of Midwifery, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.
² Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Department of Biostatistics, Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Objectives: Given the descending trend of menarche age and the effect of social determinants of health on menarche, the present study was conducted to examine the relationship model of social determinants of health with menarche age of girls.

Materials and methods: The present cross-sectional study enrolled 840 mothers and their 6-17 year-old daughters in the city of Kashan, Iran (2020). Questionnaires used included: demographic-family questionnaire for mothers and daughters, question about age at menarche, Perceived Social Support, Physical Activity, Socioeconomic Status, Spiritual Health, General Health Questionnaire, the quality of couple's relationship and the family communication pattern. The statistical analysis was performed in SPSS-16, and the relationship model was examined using path analysis method in LISREL-8.8.

Results: The girls' menarche age was directly affected by sister's (b = 0.83) and mother's menarche age (b = 0.05), BMI (b = 0.01), physical activity (b = -0.06), conversation orientation (b = -0.002), socioeconomic status (b = -0.01) and maternal general health (b = 0.009). It was also indirectly affected by mother's menarche age, social support, socioeconomic status, and maternal spiritual health and parents relationships.

Conclusions: The results showed that the numerous factors affect the girls' age at menarche directly and indirectly. Considering mutual interaction of factors revealed in the proposed model, it is recommended this model be used as an appropriate framework in research, design and implementation of programs relating to adolescent girls.

Keywords: Menarche; Menstruation; Puberty; Social determinants of health.