Association between age at menarche and gestational diabetes: a retrospective case–control study

Our study explores how the timing of menarche relates to the risk of gestational diabetes mellitus (GDM) in Mexican women, a topic that, despite its biological plausibility, has received little attention in Latin America. We found that women who experienced menarche before age 12 were more than twice as likely to develop GDM as those with an average onset. Interestingly, our spline models revealed a modest U-shaped association, suggesting that both very early and late puberty may lead to metabolic disadvantages. Mediation analysis indicated that pre-gestational adiposity only explained a small part of this relationship, highlighting the contribution of broader endocrine and developmental mechanisms.