Pubertal onset in girls from urban and rural settings of north-west Punjab: A medicolegal perspective

AbstractIntroductionThe process of female puberty is a unique process with sequential development of secondary sexual characteristics. This study aimed to examine the medicolegal importance of the onset of puberty in girls of urban and rural regions.Materials and MethodIt was a cross-sectional questionnaire-based study done in 7 to 15-year-old school girls (n=200; 100 urban, 100 rural) over 18 months in the north-west region of Punjab. Secondary sexual characteristics were evaluated according to Marshal and Tanner's (1962) recommendations for pre-defined age groups (7-9 years, 9 -11 years, 11-13 years, and 13-15 years, with each group consisting of 25 girls).ResultsThe mean age of Tanner stage 1 of breast development among urban and rural girls was 8.16 years and 7.67 years, respectively (P value 0.002). The mean age of Tanner stage 3 among urban and rural girls was 11.34 years and 12.93 years, respectively (P value <0.001). There was no statistically significant difference between stages 2 and 4. For pubic hair growth, statistical significance was noticed in Tanner stage 2 only (P value <0.001, mean age of onset among urban and rural girls being 11.82 years and 12.96 years, respectively). Similarly, the mean age of stage 2 of axillary hair growth was statistically meaningful (P value 0.006) (urban girls- 14.11 years and rural girls -13.66 years). The mean age of menarche in urban girls (among 42 girls of 100) was 12.79 years, and the mean age of menarche in rural girls (among 19 girls of 100) was 12 years (significant p value of <0.001).ConclusionThe onset of puberty and development of secondary sexual characteristics can help in assessing age of the child which has an important medico-legal importance.