Secular trend in the sexual maturation of Southern Chinese girls

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Abstract
In 1993, a cross-sectional study of sexual maturation of normal Chinese schoolgirls was performed in Hong Kong. The aim of the study was to obtain an up-to-date reference for normal pubertal development in Chinese girls. Breast development was assessed in 3749 girls aged 7–19 y, and pubic hair rating was assessed in 3745 girls. Menstrual status was recorded in 6467 girls over 6 y of age. The median age of onset of puberty as indicated by breast stage II or above was 9. 78 (95% CI 9. 70–9. 85) y. The median age of onset of pubic hair development was 11. 64 (95% CI 11. 56–11. 72) y. The median age of menarche was 12. 38 (95% CI 11. 98–12. 78) years. Percentile values for the age at which each puberty staging appeared were constructed and incorporated into the height-for-age charts. When comparison is made with similar studies done in 1962 and 1979, a significant downward secular trend in sexual maturation is observed (p < 0. 01). Except for breast development the downward secular trend in sexual maturation appears to be diminishing and may be coming to a halt in the Chinese girls in Hong Kong. Their median ages of sexual maturation are now among one of the earliest medians recorded in the world population studied.

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