Association Between Age at Menarche and the Risk of Preeclampsia in Pregnant Women: A Systematic Review and Meta-analysis

Abstract

Objective: This study aimed to examine the association between age at menarche and the risk of preeclampsia.
Methods: This study followed the PRISMA 2020 guidelines. A literature search was conducted in PubMed, Scopus, Cochrane Library, EBSCOhost, and SAGE Journals up to November 13, 2025. Observational studies assessing age at menarche and preeclampsia were included. Risk of bias was evaluated using the Newcastle-Ottawa Scale. Data were pooled using a random-effects inverse-variance model to estimate Odds Ratios (ORs) with 95% Confidence Intervals (CIs). Heterogeneity, subgroup analysis, meta-regression, sensitivity analyses, and publication bias were performed.
Results: Eight studies involving 219,933 participants with a low to moderate risk of bias were included. The analysis showed a higher risk of preeclampsia in early menarche compared to normal menarche (OR 2.84, 95% CI 1.64–4.93; p < 0.000; I² = 95%), normal menarche compared to late menarche (OR 1.56, 95% CI 1.14–2.15; p = 0.006; I² = 65%), and early menarche compared to late menarche (OR 2.40, 95% CI 1.40–4.11; p = 0.001; I² = 84%).
Conclusion: Age at menarche is associated with the risk of preeclampsia. However, the findings should be interpreted with caution due to several limitation.

Hubungan antara Usia Menarche dan Risiko Preeklampsia pada Ibu Hamil: Tinjauan Sistematis dan Meta-analisis

Abstrak
Tujuan: Penelitian ini bertujuan untuk mengevaluasi hubungan antara usia menarche dengan risiko preeklampsia.
Metode: Penelitian ini mengikuti pedoman PRISMA 2020. Pencarian literatur dilakukan pada basis data PubMed, Scopus, Cochrane Library, EBSCOhost, dan SAGE Journals hingga 13 November 2025. Studi observasional yang menilai hubungan antara usia menarche dan preeklampsia diikutsertakan. Risiko bias dinilai menggunakan Skala Newcastle-Ottawa. Analisis data dilakukan dengan model efek acak metode varians terbalik untuk menghitung Odds Ratio (OR) dengan 95% Confidence Interval (CI). Heterogenitas, analisis subkelompok, meta-regresi, analisis sensitivitas, serta bias publikasi juga dianalisis.
Hasil: Delapan studi dengan total 219.933 partisipan dengan risiko bias rendah hingga sedang diikutsertakan. Analisis menunjukkan bahwa risiko preeklampsia lebih tinggi pada menarche dini dibandingkan menarche normal (OR 2.84, 95% CI 1.64–4.93; p < 0.000; I² = 95%), menarche normal dibandingkan menarche lambat (OR 1.56, 95% CI 1.14–2.15; p = 0.006; I² = 65%), serta menarche dini dibandingkan menarche lambat (OR 2.40, 95% CI 1.40–4.11; p = 0.001; I² = 84%).
Kesimpulan: Usia menarche berhubungan dengan risiko preeklampsia. Namun, hasil ini perlu diinterpretasikan secara hati-hati karena beberapa keterbatasan.