Early Life Adversity and Pubertal Timing: Implications for Cardiometabolic Health

Maria E. Bleil, Susan J. Spieker, Steven E. Gregorich, Alexis S. Thomas, Robert A. Hiatt, Bradley M. Appelhans, Glenn I. Roisman, Cathryn Booth-Laforce

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


OBJECTIVE: To identify early life adversity (ELA) risk factors for earlier pubertal timing, itself a risk factor for poor cardiometabolic health, and to determine whether such ELA-related risk may be mediated by pre-pubertal body mass index (BMI).

METHODS: Subjects included 426 female participants in a prospective birth cohort study, the NICHD Study of Early Child Care and Youth Development. Survival analysis models were fit to examine ELA exposures, representing childhood socioeconomic status (SES), maternal sensitivity, mother-child attachment, and negative life events, along with child health indicators and covariates, in relation to pubertal timing outcomes, including age at menarche and ages at Tanner stage II for breast and pubic hair development.

RESULTS: Higher childhood SES emerged as an independent predictor of older age at menarche, showing each one standard deviation increase in childhood SES corresponded to a 1.3% increase in age at menarche (factor change = 1.013; 1.003-1.022; p < .01), but did not predict breast or pubic hair development (ps > .05). In mediation analyses, indirect (mediated) effects of mother-child attachment on the pubertal timing outcomes, via pre-pubertal BMI, were all statistically significant (ps < .05).

CONCLUSIONS: Higher childhood SES predicted directly, and secure (vs. insecure) mother-child attachment predicted indirectly (via pre-pubertal BMI), later pubertal timing, suggesting these factors may protect girls from earlier pubertal development. By extension, clinical implications are that intervention strategies designed to lessen ELA- and pre-pubertal obesity-related risk may be effective in remediating life course pathways linking ELA, accelerated pubertal development, and cardiometabolic risk.

Original languageEnglish (US)
Pages (from-to)36-48
Number of pages13
JournalJournal of pediatric psychology
Issue number1
StatePublished - Jan 1 2021

Bibliographical note

Publisher Copyright:
© 2020 The Author(s) 2020. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved.


  • cardiometabolic disease
  • chronic illness
  • endocrinology
  • family functioning
  • health behavior
  • health promotion and prevention
  • longitudinal research
  • obesity
  • parenting
  • prevention/control
  • psychosocial functioning
  • pubertal timing
  • stress
  • Cardiovascular Diseases
  • Prospective Studies
  • Humans
  • Menarche
  • Adverse Childhood Experiences
  • Female
  • Child
  • Body Mass Index
  • Puberty
  • Adolescent
  • Aged
  • Cohort Studies

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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