ABSTRACT
Growth after birth may be characterized by five stages of life, which include infancy, childhood, juvenile, adolescence and adulthood. Puberty is the process of change that occur in the body of girls, in which the body matures into adulthood. It is associated with the development of sexual characteristics as the most notable morphological changes. Menarche as a very important reproductive phenomenal changes in the life of a female was first introduced by Kish in 1910 and is defined as the first menstruation that occur in the female taking into account as the age of her puberty and maturation. Another important aspect in the reproductive life of the female that ends with some degree of suddenness is menopause. Anthropometric data are very important and have direct relationship with medical conditions of the individual. The aim of this study was to investigate the relationship between the anthropometric and reproductive characteristics of girls and women in Kumana Chiefdom, Kauru Local Government Area, Kaduna State, Nigeria. The subjects for this study were girls and women that were not pregnant and both physically and mentally fit. The girls (n = 415) were randomly drawn from the nine secondary schools and the women (n = 623) were randomly drawn from villages in the eight districts of Kumana Chiefdom, Kauru Local Government Area, Kaduna State, Nigeria. The data of this study were obtained through questionnaire from the girls and the women, while the body composition, blood pressure, some demographic and anthropometric variables were obtained through measurements following the appropriate standard protocol. The result obtained showed that mean of the hip circumference for the women and girls were 92.94 ± 8.81 cm and 86.60 ± 7.30 cm respectively. The mean waist circumference for the women and girls were 80.59 ± 9.25 cm and 75.62 ± 4.20 cm respectively. The mean of the neck circumference of the women and girls were observed to be 31.43 ± 2.61 cm and 30.27 ± 1.92 cm respectively. The mean height of the women and girls were found to be 154.84 ± 6.12 cm and 151.33 ± 5.86 cm respectively. The mean of hand lengths of the women and girls were 17.91 ± 1.29 cm and 17.53 ± 0.92 cm respectively. The 2d-4d ratio of the women and girls are 0.94 ± 0.04 cm and 0.97 ± 0.06 cm respectively. The means of palm lengths of the women and girls were found to be 10.27 ± 0.74 cm and 10.02 ± 0.65 cm respectively. The means of foot lengths of the women and girls were seen to be 23.35 ± 1.37 cm and 22.88 ± 1.45 cm respectively. The means of forearm lengths of the women and girls were found to be 24.83 ± 1.44 cm and 22.94 ± 1.05 cm respectively. The means of bone mass of the women and girls were
viii
2.02 ± 0.02 cm and 2.16 ± 0.16 cm respectively. The mean values of muscle mass of the women and girls are 38.33 ± 5.91 m2 and 39.86 ± 2.37 m2 respectively. The means of total body water percentage of the women and girls were 53.21 ± 8.65 % and 51.05 ± 5.00 % respectively. The mean values of the body mass index of the women and girls are 23.73 ± 3.71 kg/m2 and 19.77 ± 2.79 kg/m2 respectively. The mean values of the systolic blood pressure of the women and girls were 127.86 ± 19.06 and 117.95 ± 11.16 respectively. The mean values of the diastolic blood pressure of the women and girls were 81.02 ± 11.12 and 70.76 ± 9.54 respectively. The means of weight of the women and girls were 57.06 ± 9.35 kg and 45.43 ± 7.83 kg respectively. The mean menarcheal age of the women was found to be 15.58 ± 1.57 years and the mean menopausal age of the women was observed to be 47.17 ± 5.06 years. The menarcheal age of girls whose parents had attended tertiary education was observed to be lower than for the girls whose parents had attended only primary education. The menopausal age of the women was higher for the women with tertiary education, first order of birth and house wives. Girls born in the rainy season had higher menarcheal age than those born in the dry season, while women born in the rainy season were observed to have lower menarcheal age higher menopausal age was observed in women born in the rainy season than those born in the dry season, while the number of children born by a women did not have any effect on the woman’s menopausal age. Women who had tertiary education and those born in the rainy season were seen to have higher menopausal age. Left-handed girls and women were observed to have higher menarcheal age than the right-handed. The result of this study showed that, higher percentage of the women were premenopausal, only 10.11% were menopausal. Many of the women were observed not to have ever had miscarriage, few of them reported to experience menstrual pain and only 24.4% of them reported not to be menstruating, indicating that many of them have the ability to become pregnant. It was observed that the women had good perception to menopause and knowledge of menopause by these women was obtained more through teachings in the church. There was positive relationship height and hand length, palm length, forearm length, foot length, menarche and the correlation were statistically significant at p = 0.05, but the correlation between height and little finger was observed not to be statistically significant. The correlation of age at first menses with height and hand circumference were statistically significant at p < 0.01, and statistically significant with weight at p < 0.05. The correlation between menopause and age at marriage, age at first pregnancy, at first birth, at last birth were statistically significant at p < 0.01, with age at first menses statistically significant at p < 0.05. The correlation between menopause and body mass index, weight, hip circumference, digit ratio, waist circumference, neck circumference, birth order were statistically significant at p < 0.05 but with hand circumference, statistically significant at p < 0.01). The correlation between body mass index (BMI) and body circumferences was positive and significant at p < 0.05, strong positive was seen with neck and arm circumferences. It was observed that, height could only be estimated using weight and body mass index. In conclusion, it was found that the reproductive characteristics of girls and women in this study population correlated with most of the anthropometric measurements. The menarcheal and menopausal ages of the subjects were within the normal values, which indicated that the socio-economic level in this region was not below standard.
TABLE OF CONTENTS
Cover page——————————————————————————————–i
Title page ——————————————————————————————–ii
Declaration——————————————————————————————iii
Certification—————————————————————————————–iv
Dedication——————————————————————————————–v
Acknowledgement———————————————————————————-vi
Abstract——————————————————————————————–viii
Table of Contents ———————————————————————————-xi
List of Tables————————————————————————————-xvii
List of Figures———————————————————————————–xviii
List of Plates—————————————————————————————xxi
List of Appendices——————————————————————————-xxii
List of abbreviations—————————————————————————-xxiii
xi
CHAPTER ONE
1.0 INTRODUCTION—————————————————————————1
1.1 Background of study————————————————————————1
1.2 Statement of Research Problem———————————————————-5
1.3 Significance of the study——————————————————————–5
1.4 Justification of study ———————————————————————–5
1.5 Aim and objectives of the study ———————————————————-6
1.5.1 Aim of the study ——————————————————————————6
1.5.2 Objectives of the study ———————————————————————–6
1.6 Hypotheses of the study ——————————————————————–7
1.7 Limitations of the study———————————————————————7
CHAPTER TWO
2.0 LITERATURE REVIEW—————————————————————-8
2.1 Puberty in girls—————————————————————————–8
2.2 Infertility———————————————————————————–10
2.3 Menstrual cycle characteristics——————————————————–11
2.4 Adiposity———————————————————————————–14
2.5 Menarche———————————————————————————–17
2.5.1 Factors influencing age at menarche—————————————————-20
2.5.2 Health implications of early and late menarche—————————————22
2.6 Menopause———————————————————————————24
xii
2.6.1 Factors associated with early and late menopause————————————26
2.6.2 Concept and attitude of women towards menopause———————————31
2.6.3 Health implications of early and late menopause————————————-33
2.7 Stature ————————————————————————————-34
CHAPTER THREE
3.0 MATERIALS AND METHODS——————————————————36
3.1 Materials———————————————————————————–36
3.1.1 Height and weight measurements——————————————————-36
3.1.2 Measurement of blood pressure———————————————————36
3.1.3 Use of measuring Tape——————————————————————-42
3.2 Methods————————————————————————————44
3.2.1 Study Area———————————————————————————44
3.3 Study population————————————————————————-48
3.3.1 Subjects————————————————————————————-48
3.3.2 Sample determination———————————————————————48
3.3.3 Inclusion and Exclusion Criteria——————————————————–48
3.3.4 Questionnaire——————————————————————————49
3.3.5 Ethical approval—————————————————————————50
3.3.6 Data Analyses—————————————————————————–50
xiii
CHAPTER FOUR
4.0 RESULTS———————————————————————————-51
4.1 Descriptive Statistics of the Study—————————————————–51
4.2 Relationship of the reproductive characteristics with Some
Anthropometric variables————————————————————–58
4.3 Weight and body mass index of girls and women———————————85
4.4 Body circumferences and body composition of the study population———89
4.5 Perception and attitude of women to menopause———————————-93
4.6 Correlation analysis of hand and foot anthropometry—————————98
4.7 Correlation between age at first menstruation and some anthropometric
variables————————————————————————————99
4.8 Correlation of menopause with some Reproductive history of women——-99
4.9 Correlation of menopause with some anthropometric variables—————99
4.10 Correlation of body mass index with some anthropometric variables
———————————————————————————————-100
4.11 Estimation of height using some anthropometric variables——————–100
xiv
CHAPTER FIVE
5.0 DISCUSSIONS————————————————————————–108
5.1 Age at Menarche————————————————————————108
5.2 Age at Menopause———————————————————————-110
5.3 Anthropometric variables————————————————————-112
5.4 Body Composition———————————————————————-114
5.5 Correlation of the height of the girls with hand and foot anthropometry–115
5.6 Correlation of the height of the women with hand and foot anthropometry
———————————————————————————————-115
5.7 Correlation between anthropometric variables and Body composition—–116
5.8 Correlation of menopause with some reproductive history——————–117
5.9 Correlation of age at menarche with some anthropometric
Variables ———————————————————————————117
5.10 Estimation of height using some anthropometric variables——————–118
5.11 Perception, attitude and knowledge of Menopause —————————–118
CHAPTER SIX
6.0 SUMMARY, CONCLUSION AND RECOMMENDATION—————–120
6.1 Summary ———————————————————————————120
6.2 Conclusion ——————————————————————————-121
xv
6.3 Recommendation————————————————————————121
6.4 Contribution to knowledge————————————————————122
Reference—————————————————————————————–123
xvi
CHAPTER ONE
1.0 INTRODUCTION
1.1 Background of the Study
The pattern of human growth after birth may be characterized by five stages, which include infancy, childhood, juvenile, adolescence and adulthood, (Bogin and HollySmith, 1996). These stages are the life cycle of the individual that are defined by biological characteristics of which growth and sexual maturation are the two biological characteristics (Bogin and HollySmith, 1996). Menarche is the most important measure and indicator of onset of sexual maturation in a female, (Wronka and Pawlinska-Chmara, 2005; Gokhale, 2015; Song et al., 2015) and the most significant milestone in the woman’s life (Zegeye et al., 2009). The term menarche was first introduced by Kish in 1910 (Biswas and Kapoor, 2004). The reproductive life of the female is affected by sexual maturation (Dakshayani et al., 2007). Menarcheal age varies from population to population and is a sensitive indicator of various characteristics of the female population (Chumlea et al., 2003; Ikaraoha et al., 2005; Zegeye et al., 2009). This is because it is affected by multitude of factors that include; socioeconomic status, physical activity, nutritional status, literacy level, hereditary, food habits, environment, climate, altitude, occupation, genetic causes and neuro-endocrine disorders (Thomas et al., 2001; Ofuya, 2008; Zegeye et al., 2009; Pramanik et al., 2015). Karapanou and Papadimitriou (2010) in their study indicated that age at menarche is strongly correlated with body size parameters (Pramanik et al., 2015). Socio-economic status has often been evaluated by measuring such features as population size, number of children in the family and
2
education of the parents (Padez, 2003; Wronka and Pawlinska-Chmara, 2005; Kaplowitz, 2006). The age at menarche shows the effectiveness of the female reproductive hormones, luteinizing hormone (LH) and the follicle- stimulating hormone (FSH) (Ofuya, 2008). Studies suggested that menarche tends to appear earlier in life as the sanitary, nutritional and economic conditions of a society improve, (Kaplowitz, 2006) and for most females menarche occur between the age of 10 and 16 years, (Thomas et al., 2001; Zegeye et al., 2009), but it also shows remarkable range of variation, (Thomas et al., 2001) and recent menarche is associated with highly irregular cycles (Frisch, 2002). There is declining trend in age at menarche in developed countries over decades highly attributed to excessive weight gain, but study conducted by Ayele and Berhan (2013) observed that the menarcheal age was higher than that reported from the developed countries.
Anthropometric data are very important and have direct relationship with the medical conditions of individuals (Adebisi, 2008; Danborno and Oyibo, 2008). Some certain factors contribute to more rapid decline in ovarian function and understanding them is important. While at birth there are approximately 700,000 follicles in the woman’s ovaries, the number reduces markedly and by the time of last menstrual period of the woman only few follicles remain (Hunter and Rendall, 2007; Rance, 2009). Degeneration of non-growing ovarian follicles continually accelerates from time of births to menopause (Rance, 2009). Menopause is taken to be the permanent cessation of menstruation characterized by the depletion of ovarian, follicles diagnosed after 12 months of amenorrhea, is the transition from the reproductive to the non-reproductive
3
stage of women’s lives (Garrido-Latorre et al., 1996; Utian, 2004; Biswas and Kapoor, 2004; Kriplani and Banerjee, 2005; Cassou et al., 2007; Hunter and Rendall, 2007; Hong et al., 2007), it is also referred to a non facultative and irreversible cessation of fertility (Peccei, 2001) and can always be considered an adaptation which is always morphologically, physiologically and developmentally constrained by an organism’s phylogenetic heritage (Peccei, 2001). Menopausal transition is also associated with highly irregular cycles (O’connor et al., 2001; Weiss, 2001; Williams, 2006; Mackey, 2009). The phase of reproductive ageing include menopause and the endocrinology of menopause transition represents a complex interplay of actions at all levels of the hypothalamic-pituitary-ovarian axis (Santaro, 2005; Morrison et al., 2006).
Female fecundity decreases with increasing age, the process of reproductive aging varies considerably among women and some women remain highly fertile until the fifth decades of their life while some faces loss of natural fertility in their mid thirties, (Broekmans et al., 2009). Menopause occurs on average between the ages of 50 and 51years (Kuhle, 2007; Hunter and Rendall, 2007; Achie et al., 2011). The physical experience of it, is similar across temporal and spatial boundaries (Utz, 2011). Age at natural menopause may be a marker of health and ageing in which a better understanding of the determinants of its onset is therefore important (Cassou et al., 2007), menopause produce a wide range of effects on a woman behavior and psyche resulting in unpleasant symptoms (Sidhu, et al., 2005). The frequency and severity of symptoms associated with menopause differ within and between populations (Avis et al., 2001; Sievert et al., 2006), not every woman reports hot flashes and night sweats during menopause (Obermeyer, 2000; Sievert et al., 2006). Late menopause has been
4
linked to an increased risk of breast cancer (Hardy et al., 2008), while early menopause is associated with increased risk of osteoporosis (Kritz-Silverstein and Barrett-Connor, 1993; Recker et al., 2000; Hardy et al., 2008). Several studies conducted have linked left-handedness, women with down’s syndrome, increasing body mass index, depression, menstrual cycle length, parity, and smoking to early natural menopause (Harlow and Signorello, 2000; Whalley et al., 2004; Ayatollahi et al., 2005; Willis et al., 2011) and late natural menopause is found to be associated with early menarche, use of oral contraceptives, marriage, higher level of education and higher socio-economic status (Mohammad et al., 2004; Cassou et al., 2007; Achie et al., 2011), while factors as ethnicity, place of residence, marital status, family income, occupation and working condition still remain unclear (Cassou et al., 2007).
The risks of coronary heart disease, osteoporosis and osteoporotic fracture are increased in postmenopausal women due to the decrease of estrogen (Murabito et al., 2005). Therefore, it is probable that the mortality rate of early menopausal women is higher than that of normal menopausal women (Hong et al., 2007). The need to access and determine the general body composition becomes very pertinent. Diagnosis of many medical and physical disorders is another important aspect of anthropometric data in that identifying factors associated with age at menopause is important (Dvornyk et al., 2006). The perception and attitude of women towards these important reproductive changes in the female body is poor, thus the need for the women to be well informed about these changes is very important (Adewuyi and Akinade, 2010).
5
1.2 Statement of Research Problem
Anthropometric studies as well as comparative data between menarche and menopause is rarely available, or even unavailable and inaccessible on the girls and women in this study population. Variations and similarities that exist between anthropometric variables and some reproductive characteristics of the girls and women from this study population are unavailable. The need to study the attitude, perception and knowledge of the girls and women to the reproductive characteristics became imperative.
1.3 Significance of the study
The result of this study can be compared with the existing data from other parts of the country and would also provide a reference value for menarcheal age and menopausal age among the Nigerian girls and women. The result of this study may provide a reference value among Nigerian girls and women in the rural areas.
1.4 Justification of study
Anthropometric data of other minority ethnic groups are available, but none exist in this study region. Reproductive characteristics of women can be used to determine longevity of the women in this region. The perception and attitudes of females towards some reproductive characteristics would help in preparing them towards any unwanted eventualities and the need of a baseline data for the study population necessitate the reasons why this study need to be conducted.
6
1.5 Aim and objective of the study
1.5.1 Aim of the study
The aim of the study was to investigate the relationships between the anthropometric and reproductive characteristics of girls and women in Kumana Chiefdom, Kauru Local Government Area of Kaduna State, Nigeria.
1.5.2 Objectives of the study
The objectives of the study were to:-
i. describe the anthropometric characteristics of girls and women in Kumana Chiefdom.
ii. determine the pattern of reproductive characteristics of girls using mean menarcheal age.
iii. investigate the relationships between some anthropometric traits (Body mass index) and some reproductive characteristics, such as menarcheal and menopausal ages.
iv. determine the perception and attitude of the girls and women toward their reproductive changes
v. investigate relationships between (2D:4D) digit ratio, menarcheal and menopausal age in girls and women from Kumana Chiefdom.
vi. investigate the relationship between some anthropometric variables and height of the girls and women in Kumana Chiefdom
vii. determine the relationship of the reproductive characteristics and their determinants
7
1.6 Hypotheses of the study
I. There was no association between anthropometric trait and reproductive characteristics
II. The mean menarcheal age of girls and women from Kumana chiefdom is higher than the mean menarcheal age reported in studies conducted by other researchers
III. Season of birth and reproductive characteristics are strongly associated
IV. There was good perception and attitude by the women in Kumana Chiefdom to menarche and menopause
1.7 Limitations of the study
i. There was difficulty in getting permission from Principals of the Secondary Schools in which this study was conducted.
ii. There was difficulty in getting full cooperation from the women and inability of event recall of their reproductive history as well as the women inability to properly fill the research questionnaires.
iii. There was also mobility problem due to lack of good roads.
Do you need help? Talk to us right now: (+234) 08060082010, 08107932631 (Call/WhatsApp). Email: [email protected].
IF YOU CAN'T FIND YOUR TOPIC, CLICK HERE TO HIRE A WRITER»
