PHYSICAL GROWTH AND SEXUAL MATURATION OF FEMALE ADOLESCENT SICKLE CELL ANAEMIA PATIENTS SEEN IN LAGOS, NIGERIA
Abstract
Sickle cell anaemia is a genetic haematological disorder where the sickle gene is inherited
homozygously from both parents. The disease has been shown to have adverse effect on growth
and sexual development.
The evaluation of physical growth and sexual maturation of female sickle cell anaemia patients
aged 10 to 19 years seen at Lagos University Teaching Hospital Idi-Araba, Lagos and Sickle
Cell Foundation, Lagos, was carried out.
It was a cross-sectional study. One hundred and forty (140) sickle cell anaemia patients
(subjects) and an equal number of children with haemoglobin AA (controls) who were matched
for age and socio-economic class were evaluated over a five-month period.
The evaluation involved measurement of height, weight and using the figures obtained to
calculate BMI. The stages of breast and pubic hair development were determined using Tanner
staging. Socio-economic status was evaluated as proposed by Olusanya, Okpere and Ezimokhai.
Sickle cell anaemia patients showed retardation of physical growth when compared with the
controls. They were found to weigh less, having a mean weight of 41.6 ±13.3kg as against 53.2
± 12.5kg in the controls (p <0.001). The mean height of the subjects was 1.5±0.13m and that of
the controls was 1.6±0.10m (p<0.001). The mean BMI for the subjects was 17.2±2.39 and
20.2±3.09 for the controls (p<0.001).
The ages of onset and completion of sexual maturity of sickle cell anaemia patients technically
fell within normal limits. They however, lagged behind their non sickle cell anaemia
counterparts. The mean age at onset of puberty (stage II) with respect to breast development was
13.2±0.39years in the subjects and 10.5±0.51years for the controls (p<0,001). The corresponding mean for pubic hair development (PH2) was also 13.8±0.59years for the SCA
patients and 10.4±0.51years for the controls (p<0.001). Mean age at menarche for the subjects
was 14.7 ±1.68years and for controls was 12.3 ±1.33years (p<0.001).
Concerning socio-economic class and its effects on puberty, among the subjects, the number that
had achieved stage II of pubic hair development and those that were still at stage I were evenly
distributed among the three socio-economic classes. This pattern was not seen in the controls,
where the children from upper socio-economic class matured earlier than the children from the
lower class. This was the case in both breast and pubic hair development. Menarche was earlier
in the upper socio-economic class of both the sickle cell anaemia patients and the controls. The
difference in menarcheal age between the upper and the lower socioeconomic classes however,
was not significant among the subjects (p = 0.19).
Physical growth and sexual maturity though technically not delayed in the sickle cell anaemia
subjects, lagged behind those of the non sickle cell anaemia subjects. Socio-economic status did
not appear to have an appreciable effect on onset or completion of sexual maturation of the
subjects.
A longitudinal study is recommended to evaluate the point of deviation of both physical growth
pattern and sexual maturity among the sickle cell anaemia patients.
