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Methods for determining pubertal status in research studies: literature review and opinions of experts and adolescents

Published online by Cambridge University Press:  17 June 2019

I. V. Walker*
Affiliation:
Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK Primary Care and Population Sciences, University of Southampton, Southampton General Hospital, Southampton, UK
C. R. Smith
Affiliation:
Department of General Paediatrics, Southampton Children’s Hospital, Southampton, UK
J. H. Davies
Affiliation:
Department of Endocrinology, Southampton Children’s Hospital, Southampton, UK
H. M. Inskip
Affiliation:
Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
J. Baird
Affiliation:
Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
*
Address for correspondence: I. V. Walker, c/o J. Baird, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK. Email: [email protected]

Abstract

In lifecourse studies that encompass the adolescent period, the assessment of pubertal status is important, but can be challenging. We aimed to identify current methods for pubertal assessment and assess their appropriateness for population-based research by combining a review of the literature with the views of experts in the field. We searched bibliographic databases, extracted data and assessed study quality to inform a workshop with 21 experts. Acceptability of different approaches was explored with a panel of ten adolescents. We screened 11,935 abstracts, assessed 157 articles and summarised results from 38 articles. Combining these with the opinions of experts, self-assessment was found to be a practical method for use in studies where agreement with the gold standard of clinical assessment by physical examination to within one Tanner stage was acceptable. Serial measures of height and foot size accurately indicated timing of the pubertal growth spurt and age at peak height velocity, and were seen as feasible within longitudinal studies. Hormonal and radiological methods did not offer a practical means of assessing pubertal status. Assessment of voice maturation was promising, but needed validation. Young people thought that self-assessment, foot size and voice assessments were acceptable, and preferred an assessor of the same sex for clinical assessment. This review thus informs researchers working in lifecourse and adolescent health, and identifies future directions in order to improve validity of the methods.

Type
Review
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019

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References

Marshall, WA, Tanner, JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969; 44(235), 291303.10.1136/adc.44.235.291CrossRefGoogle ScholarPubMed
Marshall, WA, Tanner, JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child. 1970; 45(239), 1323.10.1136/adc.45.239.13CrossRefGoogle ScholarPubMed
Coleman, L, Coleman, J. The measurement of puberty: a review. J Adolesc. 2002; 25(5), 535550.CrossRefGoogle ScholarPubMed
Dorn, LD, Biro, FM. Puberty and its measurement: a decade in review. J Res Adolesc. 2011; 21(1), 180195.10.1111/j.1532-7795.2010.00722.xCrossRefGoogle Scholar
Schmitz, KE, Hovell, MF, Nichols, JF, et al. A validation study of early adolescents’ pubertal self-assessments. J Early Adolesc. 2004; 24(4), 357384.10.1177/0272431604268531CrossRefGoogle Scholar
Tanner, JM. Growth at adolescence, 2nd edn, 1962. Blackwell: Oxford.Google Scholar
Petersen, AC, Crockett, L, Richards, M, Boxer, A. A self-report measure of pubertal status: Reliability, validity, and initial norms. J Youth Adolesc. 1988; 17(2), 117133.CrossRefGoogle ScholarPubMed
Dorn, LD, Dahl, RE, Woodward, HR, Biro, F. Defining the boundaries of early adolescence: a user’s guide to assessing pubertal status and pubertal timing in research with adolescents. Appl Dev Sci. 2006; 10(1), 3056.CrossRefGoogle Scholar
Centre for Reviews and Dissemination. Systematic reviews: CRD’s guidance for undertaking reviews in health care. University of York; 2009 [cited 2019 20 February]; Available from: https://www.york.ac.uk/media/crd/Systematic_Reviews.pdf.Google Scholar
Howard, DM. Speechtest. 2014 [cited 2018 24 July]; Available from: https://itunes.apple.com/gb/app/speechtest/id904673964?mt=8.Google Scholar
Norris, SA, Richter, LM. Are there short cuts to pubertal assessments? Self-reported and assessed group differences in pubertal development in African adolescents. J Adolesc Health. 2008; 42(3), 259265.10.1016/j.jadohealth.2007.08.009CrossRefGoogle ScholarPubMed
Bonat, S, Pathomvanich, A, Keil, MF, Field, AE, Yanovski, JA. Self-assessment of pubertal stage in overweight children. Pediatrics. 2002; 110(4), 743747.10.1542/peds.110.4.743CrossRefGoogle ScholarPubMed
Morris, NM, Udry, JR. Validation of a self-administered instrument to assess stage of adolescent development. J Youth Adolesc. 1980; 9(3), 271280.10.1007/BF02088471CrossRefGoogle ScholarPubMed
Brooks-Gunn, J, Warren, MP, Rosso, J, Gargiulo, J. Validity of self-report measures of girls’ pubertal status. Child Dev. 1987; 58(3), 829841.CrossRefGoogle ScholarPubMed
Hergenroeder, AC, Hill, RB, Wong, WW, Sangi-Haghpeykar, H, Taylor, W. Validity of self-assessment of pubertal maturation in African American and European American adolescents. J Adolesc Health. 1999; 24(3), 201205.CrossRefGoogle ScholarPubMed
Carskadon, MA, Acebo, C. A self-administered rating scale for pubertal development. J Adolesc Health. 1993; 14(3), 190195.CrossRefGoogle ScholarPubMed
Desmangles, J-C, Lappe, JM, Lipaczewski, G, Haynatzki, G. Accuracy of pubertal Tanner staging self-reporting. J Pediatr Endocrinol Metab. 2006; 19(3), 213221.CrossRefGoogle ScholarPubMed
Rasmussen, AR, Wohlfahrt-Veje, C, Tefre de Renzy-Martin, K, et al. Validity of self-assessment of pubertal maturation. Pediatrics. 2015; 135(1), 8693.10.1542/peds.2014-0793CrossRefGoogle ScholarPubMed
Norris, SA, Richter, LM. Usefulness and reliability of tanner pubertal self-rating to urban black adolescents in South Africa. J Res Adolesc. 2005; 15(4), 609624.10.1111/j.1532-7795.2005.00113.xCrossRefGoogle Scholar
Bond, L, Clements, J, Bertalli, N, et al. A comparison of self-reported puberty using the Pubertal Development Scale and the Sexual Maturation Scale in a school-based epidemiologic survey. J Adolesc. 2006; 29(5), 709720.CrossRefGoogle Scholar
Rabbani, A, Noorian, S, Fallah, JS, et al. Reliability of pubertal self-assessment method: an Iranian study. Iran J Pediatr. 2013; 23(3), 327332.Google Scholar
Sun, Y, Tao, FB, Su, PY, China Puberty Research Collaboration. Self-assessment of pubertal Tanner stage by realistic colour images in representative Chinese obese and non-obese children and adolescents. Acta Paediatr. 2012; 101(4), e163166.10.1111/j.1651-2227.2011.02568.xCrossRefGoogle ScholarPubMed
Berg-Kelly, K, Erdes, L.Self-assessment of sexual maturity by mid-adolescents based on a global question. Acta Paediatr. 1997; 86(1), 1017.10.1111/j.1651-2227.1997.tb08822.xCrossRefGoogle ScholarPubMed
Lum, S, Bountziouka, V, Harding, S, et al. Assessing pubertal status in multi-ethnic primary schoolchildren. Acta Paediatr. 2015; 104(1), e4548.CrossRefGoogle ScholarPubMed
Pereira, A, Garmendia, ML, Gonzalez, D, et al. Breast bud detection: a validation study in the Chilean growth obesity cohort study. BMC Womens Health. 2014; 14, 96.CrossRefGoogle ScholarPubMed
Karlberg, J, Kwan, C-W, Gelander, L, Albertsson-Wikland, K. Pubertal growth assessment. Horm Res. 2003; 60(Suppl 1), 2735.Google ScholarPubMed
Bundak, R, Darendeliler, F, Gunoz, H, et al. Analysis of puberty and pubertal growth in healthy boys. Eur J Pediatr. 2007; 166(6), 595600.CrossRefGoogle ScholarPubMed
Cole, TJ, Donaldson, MDC, Ben-Shlomo, Y. SITAR--a useful instrument for growth curve analysis. Int J Epidemiol. 2010; 39(6), 15581566.CrossRefGoogle Scholar
Cole, TJ, Pan, H, Butler, GE. A mixed effects model to estimate timing and intensity of pubertal growth from height and secondary sexual characteristics. Ann Hum Biol. 2014; 41(1), 7683.CrossRefGoogle ScholarPubMed
Frysz, M, Howe, LD, Tobias, JH, Paternoster, L. Using SITAR (SuperImposition by Translation and Rotation) to estimate age at peak height velocity in Avon Longitudinal Study of Parents and Children. Wellcome Open Res. 2018; 3, 90.10.12688/wellcomeopenres.14708.1CrossRefGoogle ScholarPubMed
Mitra, S, Samanta, M, Sarkar, M, Chatterjee, S.Foot length as a marker of pubertal onset. Indian Pediatr. 2011; 48(7), 549551.10.1007/s13312-011-0092-zCrossRefGoogle ScholarPubMed
Busscher, I, Kingma, I, Wapstra, FH, et al. The value of shoe size for prediction of the timing of the pubertal growth spurt. Scoliosis. 2011; 6, 11.10.1186/1748-7161-6-1CrossRefGoogle ScholarPubMed
Ford, KR, Khoury, JC, Biro, FM. Early markers of pubertal onset: height and foot size. J Adolesc Health. 2009; 44(5), 500501.CrossRefGoogle ScholarPubMed
Greulich, W, Pyle, SI. Radiographic atlas of skeletal development of the hand and wrist. 2nd edn, 1959. Stanford University Press: Stanford, CACrossRefGoogle Scholar
Tanner, JM, Whitehouse, RH, Cameron, N. Assessment of skeletal maturity and prediction of adult height (TW3 Method). 3rd edn, 2001. W.B Saunders: London.Google Scholar
Cericato, GO, Bittencourt, MAV, Paranhos, LR. Validity of the assessment method of skeletal maturation by cervical vertebrae: a systematic review and meta-analysis. Dentomaxillofac Radiol. 2015; 44(4), 20140270.CrossRefGoogle ScholarPubMed
Canavese, F, Charles, YP, Dimeglio, A, et al. A comparison of the simplified olecranon and digital methods of assessment of skeletal maturity during the pubertal growth spurt. Bone Joint J. 2014; 96-B(11), 15561560.10.1302/0301-620X.96B11.33995CrossRefGoogle ScholarPubMed
Ozer, T, Kama, JD, Ozer, SY. A practical method for determining pubertal growth spurt. Am J Orthod Dentofacial Orthop. 2006; 130(2), 131.e131–136.CrossRefGoogle ScholarPubMed
Apter, D, Bützow, T, Laughlin, GA, Yen, SS. Accelerated 24-hour luteinizing hormone pulsatile activity in adolescent girls with ovarian hyperandrogenism: relevance to the developmental phase of polycystic ovarian syndrome. J Clin Endocrinol Metab. 1994; 79(1), 119125.Google ScholarPubMed
Grumbach, MM, Roth, JC, Kaplan, SL, Kelch, RP. Hypothalamic-pituitary regulation of puberty in man: Evidence and concepts derived from clinical research. In Control of the onset of puberty. 1974; pp. 115166. John Wiley & Sons: New York.Google Scholar
Søeborg, T, Frederiksen, H, Mouritsen, A, et al. Sex, age, pubertal development and use of oral contraceptives in relation to serum concentrations of DHEA, DHEAS, 17α-hydroxyprogesterone, Δ4-androstenedione, testosterone and their ratios in children, adolescents and young adults. Clin Chim Acta. 2014; 437, 613.CrossRefGoogle Scholar
Sehested, A, Andersson, AM, Müller, J, Skakkebaek, NE. Serum inhibin A and inhibin B in central precocious puberty before and during treatment with GnRH agonists. Horm Res. 2000; 54(2), 8491.Google ScholarPubMed
Singh, GKS, Balzer, BWR, Kelly, PJ, et al. Urinary sex steroids and anthropometric markers of puberty—a novel approach to characterising within-person changes of puberty hormones. PLoS One. 2015; 10(11), e0143555.CrossRefGoogle ScholarPubMed
Shirtcliff, EA, Dahl, RE, Pollak, SD. Pubertal development: correspondence between hormonal and physical development. Child Dev. 2009; 80(2), 327337.CrossRefGoogle ScholarPubMed
Ankarberg-Lindgren, C, Norjavaara, E. Changes of diurnal rhythm and levels of total and free testosterone secretion from pre to late puberty in boys: testis size of 3 ml is a transition stage to puberty. Eur J Endocrinol. 2004; 151(6), 747757.10.1530/eje.0.1510747CrossRefGoogle ScholarPubMed
Chada, M, Prusa, R, Bronsky, J, et al. Inhibin B, follicle stimulating hormone, luteinizing hormone and testosterone during childhood and puberty in males: changes in serum concentrations in relation to age and stage of puberty. Physiol Res. 2003; 52(1), 4551.Google ScholarPubMed
Crofton, PM, Evans, AEM, Groome, NP, et al. Dimeric inhibins in girls from birth to adulthood: relationship with age, pubertal stage, FSH and oestradiol. Clin Endocrinol (Oxf). 2002; 56(2), 223230.10.1046/j.0300-0664.2001.01449.xCrossRefGoogle ScholarPubMed
Rockett, JC, Lynch, CD, Buck, GM. Biomarkers for assessing reproductive development and health: Part 1--Pubertal development. Environ Health Perspect. 2004; 112(1), 105112.CrossRefGoogle ScholarPubMed
Brann, DW, Wade, MF, Dhandapani, KM, Mahesh, VB, Buchanan, CD. Leptin and reproduction. Steroids. 2002; 67(2), 95104.10.1016/S0039-128X(01)00138-6CrossRefGoogle ScholarPubMed
Mantzoros, CS, Flier, JS, Rogol, AD. A longitudinal assessment of hormonal and physical alterations during normal puberty in boys. V. Rising leptin levels may signal the onset of puberty. J Clin Endocrinol Metab. 1997; 82(4), 10661070.Google ScholarPubMed
Wang, T, Morioka, I, Gowa, Y, et al. Serum leptin levels in healthy adolescents: effects of gender and growth. Environ Health Prev Med. 2004; 9(2), 4146.CrossRefGoogle Scholar
Carlsson, B, Ankarberg, C, Rosberg, S, et al. Serum leptin concentrations in relation to pubertal development. Arch Dis Child. 1997; 77(5), 396400.CrossRefGoogle ScholarPubMed
Maqsood, AR, Trueman, JA, Whatmore, AJ, et al. The relationship between nocturnal urinary leptin and gonadotrophins as children progress towards puberty. Horm Res. 2007; 68(5), 225230.Google ScholarPubMed
Zaman, N, Hall, CM, Gill, MS, et al. Leptin measurement in urine in children and its relationship to other growth peptides in serum and urine. Clin Endocrinol (Oxf). 2003; 58(1), 7885.10.1046/j.1365-2265.2003.01677.xCrossRefGoogle ScholarPubMed
Harries, ML, Walker, JM, Williams, DM, Hawkins, S, Hughes, IA. Changes in the male voice at puberty. Arch Dis Child. 1997; 77(5), 445447.CrossRefGoogle Scholar
Hodges-Simeon, CR, Gurven, M, Cardenas, RA, Gaulin, SJC. Voice change as a new measure of male pubertal timing: a study among Bolivian adolescents. Ann Hum Biol. 2013; 40(3), 209219.CrossRefGoogle ScholarPubMed
Ong, KK, Bann, D, Wills, AK, et al. Timing of voice breaking in males associated with growth and weight gain across the life course. J Clin Endocrinol Metab. 2012; 97(8), 28442852.CrossRefGoogle ScholarPubMed
Cooksey, JM. The male adolescent changing voice: Some new perspectives. In Research symposium on the male adolescent voice. (ed. Runfola, M), 1984; pp. 459. State University of New York Press: Buffalo.Google Scholar
Dorn, LD. Measuring puberty. J Adolesc Health. 2006; 39(5), 625626.10.1016/j.jadohealth.2006.05.014CrossRefGoogle ScholarPubMed
Carel, JC, Leger, J. Clinical practice. Precocious puberty. N Engl J Med. 2008; 358(22), 23662377.CrossRefGoogle ScholarPubMed
Taylor, SJ, Whincup, PH, Hindmarsh, PC, et al. Performance of a new pubertal self-assessment questionnaire: a preliminary study. Paediatr Perinat Epidemiol. 2001; 15(1), 8894.10.1046/j.1365-3016.2001.00317.xCrossRefGoogle ScholarPubMed
Duke, PM, Litt, IF, Gross, RT. Adolescents’ self-assessment of sexual maturation. Pediatrics. 1980; 66(6), 918920.Google ScholarPubMed
Gerver, WJ, de Bruin, R. Paediatric morphometrics: a reference manual, 2001. University Press Maastricht: Maastricht.Google Scholar