Studies in Sickle Cell Anemia: XXVI. The Effects of Homozygous Sickle Cell Disease on the Onset of Menarche, Pregnancy, Fertility, Pubescent Changes, and Body Growth in Negro Subjects

EARLIER clinical observations have suggested that patients with sickle cell disease tend to show an increased incidence of complications during labor,^1,2 a tendency to lowered fertility,^3,4 characteristic hypoplastic genitalia,^5,6 eunuchoid habitus,^6-11 and are often smaller than their nonanemic siblings.^11,12

Studies previously reported by Michelson¹³ that the average age of menarche in Negroes (with a comparative study by Boas,¹⁴ Simmons and Greulich,¹⁵ on the age of menarche among white girls), was 12.94±1.1 years in the northern states and 13.68±1.4 years in the southern part of the United States. This variation in the onset in the different regions was believed to be due to a better socioeconomic status of Negroes in the north according to Michelson,¹³ Engelsman,¹⁶ and Gould and Gould.¹⁷

During the past three decades, the age of onset of puberty has decreased by ten months in Negroes and