Pubertal Maturation and Growth Trends of School Girls in Delhi from 2017-2020

Growth patterns are influenced by gender, race, nutrition, genetics and environment and have shown secular trends as per available data from India. This study aimed to measure the growth patterns in school-going girls from Northern India.

This prospective cohort study enrolled school-going girls aged 3-18 years in year 2018 after parental consent and assent. Weight and height were recorded during school visits on six monthly intervals for a period of 30 months. Pubertal assessment was done annually. Height velocity was computed on an annual basis. The age at onset of puberty and its progression trends were also recorded.

A total of 2470 girls (n = 1413 had normal body mass index) with mean (SD) age 10.17 (3.29) years were enrolled. 1354 (54.8%) and 929 (37.6%) girls completed follow-up at 12 and 30 months, respectively. The mean (SD) age at thelarche (n = 341) and menarche (n = 552) was 10.13 (0.99) and 11.94 (1.14) years, respectively. The first-year height velocity (HV) was maximum in girls at pubertal stage 2 at 6.07 (1.86) cm/year as compared to other stages; P < 0.001. The age of thelarche and menarche was earlier in overweight/obese girls than normal BMI (P < 0.001). A significant negative correlation was seen between BMI and age at thelarche (r = - 0.113; P = 0.032) and first-year HV (r = -0.303; P < 0.001). When categorized as per pubertal onset, girls who were early maturers had higher BMI and higher height velocity than normal or late maturers (P < 0.05).

School going girls had a maximum growth velocity at stage 2 of puberty. A secular pattern was seen across pubertal stages as compared to the last decade.