It is generally admitted that ovulation and menstruation, while coincidental, are not interdependent, the former, in fact, occurring periodically for some time prior to puberty, while the latter constitutes the final sign of sexual maturity. Accordingly, impregnation may take place before the advent of menstruation, and instances of this character, while unusual, can not be considered as extraordinary. Dr. A. W. Addinsell2 reports that a 13-year-old girl was delivered of a 7-month's still-born child, although she had never menstruated or previously had presented any other outward sign of sexual maturity. He also refers to the case of a girl who gave birth to a child at the age of 9 years and to similar cases in girls of 11¾, 12 and 12½ years, but who had previously menstruated. He further calls attention to the fact that maternity before the advent of menstruation is not uncommon in Central Africa and
PREMENSTRUAL PREGNANCY. JAMA. 1905;XLIV(20):1620. doi:10.1001/jama.1905.02500470048013
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