Impacts of fetal/infant and adolescent exposure to famine on age at menopause in Chinese women

Background

Early-life nutritional deprivation may influence lifelong health, but its role in the broader process of reproductive aging remains underexplored. Guided by the Developmental Origins of Health and Disease framework, this study investigates the impacts of fetal/infant and adolescent exposure to famine on age at natural menopause, a key indicator of reproductive aging.

Methods

The study sample comprised 4256 women from the China Health and Retirement Longitudinal Study. Participants were categorized into fetal/infant (1959–1962 births) or adolescent (1942–1946 births) famine-exposed cohorts and non-exposed controls. Multivariable linear and logistic regression models were used to assess associations between famine exposure and age at natural menopause or early menopause, adjusting for sociodemographic, economic, and behavioral covariates.

Results

Famine exposure was associated with an earlier age at natural menopause: 1.16 years earlier for fetal/infant exposure (β = −0.12, p = 0.002), and 0.72 years earlier for adolescent exposure (β = −0.07, p = 0.014); it was also associated with increased odds of early menopause (odds ratio [OR] = 1.05, 95 % confidence interval [CI] 1.01–1.10). No significant association with premature menopause was observed.

Conclusion

Nutritional deprivation during critical developmental windows—particularly adolescence—has distinct, long-term effects on the trajectory of reproductive aging. These observational findings, which cannot establish causality, underscore the importance of early-life nutrition in shaping female reproductive health and are consistent with the Developmental Origins of Health and Disease framework in reproductive health.