Association of menarche age with macrosomia and modified effect from dietary pattern: findings from the Chinese pregnant women

Background Age at menarche (AAM) is increasingly identified as essential factor of various perinatal complications. However, evidence on AAM with incident macrosomia remains to be determined, as does the potential modifying effect of behavioral factors. This study aimed to examine the prospective association between earlier AAM and development of macrosomia and to evaluate whether dietary patterns modify this association. Methods This prospective cohort study comprised 2,554 Chinese women from Xi'an Birth Cohort. AAM was ascertained by self-report. Dietary intake was evaluated using a validated semi-quantitative food frequency questionnaire, and principal component analysis was used to derive three dietary patterns, named “meat, shrimp, and fish,” “vegetables, soybean and soybean products” and “animal offal, processed meat, and baked food.” Binary logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for risk of macrosomia associated with AAM and dietary patterns. The non-linear relationships between AAM and macrosomia were explored by restricted cubic splines. Stratified analyses were conducted to examine the roles of dietary patterns. Results Compared with women experienced menarche between 13 and 15 years, women with menarche before age 13 years had a higher risk of macrosomia (OR: 1.90; 95% CI: 1.37–2.62, P for non-linear < 0.05). Adhering to the “meat, shrimp, and fish” dietary pattern exhibited a reduced risk of macrosomia (OR: 0.64, 95% CI: 0.46–0.89). Similarly, following the “vegetables, soybeans, and soybean products” dietary pattern demonstrated a 52% reduction in the risk of macrosomia (OR: 0.48, 95%CI: 0.33–0.70). But the processed food dietary pattern increased the risk by 1.23 times (OR: 2.23, 95% CI: 1.42–3.50). Dietary may influence the odds of macrosomia in earlier AAM. Conclusions Earlier AAM is associated with higher risk of macrosomia. This risk may be attenuated by following a vegetables and soy products diet model but exacerbated by adhered to a processed foods diet. These findings highlight the potential for dietary habits to modify for macrosomia, particularly among women with early menarche.