MENARCHEAL AGE AND BREAST DEVELOPMENT

IN PURWOKERTO

ARVINA OKTAVIANI

DEPARTMENT OF BIOLOGY

FACULTY OF MATHEMATICS AND NATURAL SCIENCE

BOGOR AGRICULTURAL UNIVERSITY

BOGOR

2014

STATEMENT ABOUT UNDERGRADUATE THESIS,

INFORMATION SOURCES, AND ACT OF SPILLING OVER

COPYRIGHTS*

By this writing I clarify that the undergraduate thesis Cognitive Style and

Working Memory of the First Year Undergraduate IPB Student is my own work

under the supervisions of the advising committee and hasn’t been proposed for

any institution. Copied information source of published and unpublished writing

of other author has been mentioned in the text and incorporated in the references

at the last part of this thesis.

By this writing I hand over the copyright of my thesis to Bogor Agricultural

University.

Bogor, April 2014

Arvina Oktaviani

NIM G34090077

ii

ABSTRACT

ARVINA OKTAVIANI. Menarcheal Age and Breast Development in

Purwokerto. Supervised by BAMBANG SURYOBROTO and PUJI RIANTI.

Puberty is a transition from childhood into adulthood. It occurs as a result of

the hypothalamic pituitary gonadal axis activity which stimulates the central

inhibitory feedback and lifts the Gonadotropin Releasing Hormone (GnRH). The

activation of GnRH increasingly stimulates the secretion of Follicle Stimulating

Hormone (FSH) and Lutenizing Hormone (LH) from the pituitary gland. Both of

these hormones stimulate the production of estrogen, which allows for menarche

and the development of secondary sexual characteristics. The aim of this research

is determine the menarcheal age and breast development in Purwokerto. I used 99

individual subject aged 8-14 years old which contained 28 menarche subjects. The

result showed that the menarcheal age average in Purwokerto was 12.4 years old.

In this study, the breast measurement showed three stages of breast development.

The youngest and the average age of Tanner stage two were 9 and 10 years old.

The youngest and average age of Tanner stage three were 10.8 and 12.5 years old.

Based on the result, menarche has correlated with the breast development stage

three. The present study had similar result between Bogor, Jakarta, but differ with

Pekalongan. This maybe because the samples from Purwokerto, Bogor, and

Jakarta came from urban areas whereas samples from Pekalongan came from rural

area.

Keywords: breast development, menarche, nutrition status, puberty, and

socioeconomic status

ABSTRAK

ARVINA OKTAVIANI. Menarcheal Age and Breast Development in

Purwokerto. Dibimbing oleh BAMBANG SURYOBROTO and PUJI RIANTI.

Pubertas adalah masa transisi dari kanak-kanak menjadi dewasa. Hal ini

terjadi sebagai akibat dari aktivitas hipofisis gonad sumbu hipotalamus yang

merangsang umpan balik hambat pusat dan menstimulasi Gonadotropin Releasing

Hormone (GnRH). Aktivasi GnRH merangsang sekresi Follicle Stimulating

Hormone (FSH) dan Lutenizing Hormone ( LH ) dari kelenjar pituitari. Kedua

hormon ini merangsang produksi estrogen yang memungkinkan untuk menarke

dan perkembangan karakteristik seksual sekunder. Tujuan dari penelitian ini untuk

menentukan umur menarke dan perkembangan payudara di Purwokerto. Saya

menggunakan 99 subyek usia 8-14 tahun yang terdiri dari 28 subjek yang telah

menarke. Hasil penelitian menunjukkan bahwa rata-rata usia menarke di

Purwokerto adalah 12.4 tahun. Pengukuran payudara menunjukkan tiga tahap

perkembangan payudara. Usia termuda dan rata-rata Tanner tahap dua adalah 9

dan 10 tahun. Usia termuda dan rata-rata Tanner tahap tiga adalah 10.8 tahun dan

12.5 tahun. Berdasarkan hasil, menarke berkorelasi dengan perkembangan

payudara tahap tiga. Penelitian ini memiliki hasil yang sama antara Bogor dan

Jakarta tetapi berbeda dengan Pekalongan. Hal ini mungkin karena sampel

Purwokerto, Bogor, dan Jakarta berasal dari daerah perkotaan sedangkan sampel

Pekalongan berasal dari daerah pedesaan.

Kata kunci: menarke, perkembangan payudara, pubertas, status nutrisi, status

sosial ekonomi

iii

An Undergraduate Thesis

Intended to Acquire Bachelor Degree

In Faculty of Mathematics and Natural Science

MENARCHEAL AGE AND BREAST DEVELOPMENT

IN PURWOKERTO

ARVINA OKTAVIANI

DEPARTMENT OF BIOLOGY

FACULTY OF MATHEMATICS AND NATURAL SCIENCE

BOGOR AGRICULTURAL UNIVERSITY

BOGOR

2014

iv

v

Undergraduate Thesis Title : Menarcheal Age and Breast Development in

Purwokerto

Name : Arvina Oktaviani

NIM : G34090077

Approved by

Dr Bambang Suryobroto

Supervisor I

Puji Rianti, MSi

Supervisor II

Acknowledged by

Dr Ir Iman Rusmana, MSi

Head of Department Biology

Pass Date:

vi

FOREWORDS

All praise to Allah SWT for all the hope and gift I’ve got this far. This

research is made through an experiment entitled Menarcheal Age and Breast

Development in Purwokerto City and Surroundings which was conducted from

February until June 2013 on IPB.

Biggest acknowledgements are sending to Dr Bambang Suryobroto and Puji

Rianti, MSi as my supervisor for the advice and supervisions. Special

acknowledgment are sending to Mama, Bapak, Vandavinaz, Yujum, Bunda,

Panda, Tante Danti, Om Agus, Mas Yaya and Ade, and also to all of big family in

Purwokerto for all their love and support. To Mas Iyo, Mba Tita, Ayoy, Dobreg,

Nessa, Mayo for the patience to keep give me strength and support. To,

Temaram’s girl, Mba Kanchee, Kak Sarah, Mita, Kak Nunuz, Kak Nengnong,

Ziah, Okta and Heca for the emotional support. To all of my friends in Biologi46

and ZooCorner family for the spirit this far.

At last, I hope this research will be helpful for all the readers.

Bogor, April 2014

Arvina Oktaviani

vii

TABLE OF CONTENTS

LIST OF TABLES viii

LIST OF FIGURES viii

LIST OF APPENDIXES viii

INTRODUCTION 1

Background 1

MATERIALS AND METHODS 2

Time and Place 2

Sampling 2

Informed Consent 2

Determination 2

Menarcheal Age 2

Statistical Analysis 3

RESULTS 3

CONCLUSION 6

REFERENCES 6

APPENDIXES 9

CURRICULUM VITAE 13

viii

LIST OF TABLES

1 Categories of food expenditures 3 2 Total subject who has or has not menstruate per age group 4 3 Correlation of menarcheal age and family food expenditure 5 4 Comparison of menarcheal age with other areas 5

LIST OF FIGURES

1 Estimation of menarcheal age 4 2 Breast development 4

LIST OF APPENDIXES

1 Example of informed consent 10 2 Example of research questionnaires 11

1

INTRODUCTION

Background

Puberty is a transition from childhood into adulthood. It occurs as a result of

the hypothalamic pituitary gonadal axis activity. This activity stimulates the

central inhibitory feedback and lifts the Gonadotropin Releasing Hormone

(GnRH) pulse generator. For girls, the activation of GnRH increasingly stimulates

the secretion of Follicle Stimulating Hormone (FSH) and Lutenizing Hormone

(LH) from the pituitary gland. Both of these hormones stimulate the production of

estrogen, which allows for menarche (first menstruation) and the development of

secondary sexual characteristics (Rosen 2004). Menarche is the milestone that

indicates the capacity to reproduce (Rees 1993; Burt and McCartney 2010). This

event occurs mid to late puberty, after developmental events of secondary sexual

characteristics have occurred (Mansfield and Stubbs 2004).

Development of secondary sexual characteristics includes the growth of

pubic and axillary hairs, and development of breasts (Fox 2002). Breasts develop

through accumulation of fat and other connective tissues. Breast development can

be classified into five stages (Marshall and Tanner 1969). The first stage is called

pre-adolescent or pre-pubertal stage. In this stage, elevation of bud is occurring

only in the papilla. The second stage is called thelarche, where elevation occurs in

breast and papilla as a small mound and the areola diameter becomes large. In this

stage, puberty occurs. In the third stage, further enlargement of breast and areola

occurs without separation of their contours. In the fourth stage, the areola and

papilla are forming a secondary mound above the level of the breast. The last

stage is the mature stage, in which projection only occurs in the papilla, due to

recession of the areola to the general contour of the breast (Marshall and Tanner

1969). Fat accumulation relates to nutrition which fulfills needs of the body

(Hoffman et al. 2006).

Nutrition and socioeconomic status are some of determinants in the

menarcheal age (Karapanou and Papadimitriou 2010). Both of these determinants

are correlated. In Nigeria, the menarcheal age of girls with better socioeconomic

status were significantly earlier than those with the lesser socioeconomic status

(Ikaraoha et al. 2005). Similar studies have been conducted in other cities in

Indonesia which were Bogor, Pekalongan, and Jakarta, and other countries which

were Canada, France, Iran, and Kuwait. The urban living environment is

associated with better nutrition and living conditions, whereas a rural living

environment is associated with malnutrition and less good living conditions

(Kawulur et al. 2010).

There are many urban areas in Indonesia which have not been studied yet,

for examples Purwokerto. Purwokerto is the capital city of Banyumas, Central

Java. Based on the population census in 2010, the total population in Purwokerto

is 218,277 individuals consist of 111,135 men and 107,412 women (BPS 2012).

The aim of this research is to determine the menarcheal age and breast

development in Purwokerto.

2

MATERIALS AND METHODS

Time and Place

The research was held on February until June 2013. Sampling was done in

Elementary Schools and Junior High Schools in Purwokerto. Data was analyzed

in Biosystematics and Ecology of Animals, Department of Biology, Bogor, IPB.

Sampling

The subjects of this research are girls between 8-14 years old. The numbers

of subjects used in this research are 99 individuals.

Informed Consent

Subjects were asked an informed consent. Before the tests begin, the

researcher stated the purpose of the research and the form of agreement. The

informed consent was administrated to the subject parents. When they agreed, the

informed consent was signed and completed the questionnaires.

Determination

Menarcheal Age

The menarcheal age was determined using status quo and recall methods

(Karapanou and Papadimitrou 2010). The status quo method is to ask if the

subject has or has not menstruated. The memory method is used to determine

from the subject’s memory at what age the first menstruation occurred. If the

subject is only considering the age of first menstruation, then the menstruation

date is considered to be the 1st of January in the calendar year. Otherwise, if the

subject is only considering the calendar year, then the menstruation date is

considered to be the 1st of July.

Breast Development

Breast development level was determined using anthroposcopy method by

breast observation directly. The stages of breast development determined

according to the Tanner classification (Marshall and Tanner 1969). I observed the

breast on the right side and asked the subject to took off the breast cover for direct

observation.

Nutrition and Socioeconomic Status

Family food expenditure per month was used to determine the nutrition

status and socioeconomic status. It was asked in questionnaires with 4 categories

of family food expenditure.

3

Table 1 Category of family food expenditure

Category Family Food Expenditure per Month (n, Rp)

1 n ≤ Rp500 000

2 Rp500 000≤ n ≤ Rp1 000 000

3 Rp1 000 000 ≤ n ≤ Rp1 500 000

4 n > Rp1 500 000

Statistical Analysis

The percentage of subject who has or has not menstruated was calculated for

each classes of age. The statistical analysis was done using Probit-GLM method

(Venables and Ripley 1999) implemented in R program version 3.0.1. This

method was determined to discover the menarcheal age average and breast

development stages.

RESULTS

I used 99 individual subjects, aged 8-14 years old, which contained 28

menarche subjects (Table 1). The average of menarcheal age in Purwokerto was

12.4 years old. Menarcheal age was categorized into early maturers which had

probability below 11.6 years old (less than 25 percentile); average maturers which

had probability between 11.6 to 13.1 years old (26-75 percentile); and late

maturers which had probability more than 13.1 years old (76 percentile and over)

(Figure 1).

Figure 1 Estimation of menarcheal age

Pro

bab

ilit

y

Age (years)

4

Table 2 Total subject who has or has not menarche and stage of breast

development per age group

Age

(years)

Not

Menstruated

Menstruated Breast Development

1 2 3

8 3 0 3 0 0

8.5 4 0 4 0 0

9 12 0 11 1 0

9.5 7 0 5 2 0

10 7 0 4 3 0

10.5 8 0 4 4 0

11 10 2 0 11 1

11.5 7 0 0 7 0

12 4 5 0 4 5

12.5 4 7 0 5 6

13 3 4 0 3 4

13.5 2 4 0 2 4

14 0 6 0 0 6

Total 71 28 31 42 26

In this 8-14 years old study, the breast measurement showed three stages of

breast development. The youngest age of first recognizable enlargement of breasts

(Tanner stage two) occurred at 9 years old with the average age was 10 years old.

In the other hand, the youngest age of Tanner stage three was 10.8 years old with

the average age was 12.5 years old (Table 2; Figure 2). Based on the result,

menarche had correlation with the breast developmental stage three.

Figure 2 Breast development

Age (years)

Bre

ast

Dev

elopm

ent

4

5

The family food expenditure was gotten from 24 subjects of 28 menarche

subjects. These are the subjects that completed the family food expenditure

question in the questionnaires (Table 2). If we use Rp1 000 000 as cut off, about

half of them were lower and half other upper socioeconomic statuses. There were

no correlation between these socioeconomic levels and menarcheal age.

Table 3 Correlation of menarcheal age and family food expenditure

Food Expenditure per Month

(n, Rp)

Menarcheal age Total

Subject

Percentage

(%) 10 11 12 13

n ≤ Rp500 000 1 3 1 1 6 25

Rp500 000 ≤ n ≤ Rp1 000 000 0 3 4 0 7 29.2

Rp1 000 000 ≤ n ≤ Rp1 500 000 1 1 3 0 5 20.8

n > Rp1 500 000 0 3 2 1 6 25

Total 2 10 10 2 24 100.00

DISCUSSION

Puberty is a transition from childhood into adulthood marked by changes in

reproduction ability and development of secondary sexual characteristics. The

average of menarcheal age in Purwokerto was 12.4 years old. It is similar with

Bogin’s statement (1999) that menarcheal age occurred in the median age of 12.1–

13.5 years old. The comparison between present result with other areas showed

that the oldest menarcheal age is in Nigeria (Ikaraoha et al. 2005). (Table 4).

Table 4 Comparison of menarcheal age with other areas

Author Years Area (Urban/ Rural) Average Age at

Menarche

Ikaraoha et al. 2005 Nigeria (rural) 13.2

Suhartini 2007 Bogor (urban) 12.4

Ulinnuha 2008 Pekalongan (rural) 13.3

Alchoiriah 2010 Jakarta (urban) 12.4

Al-Sahab et al. 2010 Canada (urban) 12.7

Gaudineau et al. 2010 France (urban) 12.8

Golchin et al. 2012 Iran (urban) 12.6

Al-Awadhi et al. 2013 Kuwait (urban) 12.4

Oktaviani Present study Purwokerto (urban) 12.4

Menarche is the first external indicator of reproduction ability although

breast starts to develop prior to this event. The youngest age of thelarche was at 9

years old. The thelarche (Tanner stage two; Marshall and Tanner 1969) is onset of

breast development, recognized by visible elevation of areola and papilla

mammae. Menarche usually occurred in the breast development stage three.

6

Likewise the result on this study, menarche occurs in correlation to breast

development stage three. Breast develops through accumulation of fat and other

connective tissues (Hoffman et al. 2006) and brought about primarily by the

influence of estrogens. Fat is deposited and functions as a matrix allowing

epithelial glandular proliferation. It is proposed that fat mass is a facilitator for the

timing of puberty in girls (Garcia-Mayor et al. 1997). Fat will be accumulated in

breast during more or less 2.4 years before menarche. This result similar with

previous study in Iran which is the duration is 2.4 years (Rabbani et al. 2010).

This accumulation related to nutrition which fulfills the needs of body. If nutrition

is excessive, fat will be more formed. On the other hand, if nutrition is lack, fat

will be less formed.

Nutrition and socioeconomic status are some of determinants in

menarcheal age (Karapanou and Papadimitriou 2010). Normal growth pattern can

be obtained from healthy subject with a good nutrition and good family

socioeconomic background. Nutrition and socioeconomic status can be seen from

family food expenditure (Suhartini 2007). Based on Keputusan Gubernur Jawa

Tengah no 561.4/58/2012, the minimum wage of Banyumas is Rp 877,500.00.

About half of population spent food expenditure at less than minimum wage. It is

shown that girls with low family food expenditure could grow normally and did

not lack nutrition; however, present sample was too small to draw any conclusion.

The present study had similar result between Bogor (Suhartini 2007) and

Jakarta (Alchoiriah 2010) but differ with Pekalongan (Ulinnuha 2008) (Table 4).

This maybe because of the samples from Purwokerto, Bogor, and Jakarta came

from urban areas whereas samples from Pekalongan came from rural area. This

comparison also conducted between present study in Purwokerto with other

countries, which were Nigeria (Ikaraoha et al. 2005), Canada (Al-Sahab et al.

2010), France (Gaudineau et al. 2010), Iran (Golchin 2012), and Kuwait (Al-

Awadhi et al. 2013). The comparison showed that the youngest menarcheal ages

are in Indonesia (Purwokerto) and Kuwait. Meanwhile, the oldest menarcheal age

was in Nigeria (Table 4). These differences occurred because the studies in

Indonesia, Kuwait, Iran, Canada, and French came from the urban environments

(Etemadifar et al. 2006; Wilson et al. 2009; Gaudineau et al. 2010; Al-Awadhi et

al. 2013) which had better socioeconomic status whereas samples from Nigeria

came from poor country (Ifinedo 2006) which had lesser socioeconomic status.

Girls who lived in urban area got menarche earlier than whom lived in rural area.

CONCLUSION

The average of menarcheal age in Purwokerto was 12.4 years. Thelarche

and breast development stage three occurred at the average age of 10 and 12.5

years. Menarche occurred in the breast development stage three.

REFERENCES

Alchoiriah R. 2010. Usia Maturasi Seksual Perempuan Betawi [skripsi]. Bogor

(ID): Institut Pertanian Bogor.

6

7

Al-Awadhi N, Al-Kandari N, Al-Hasan T, AlMurjan D, Ali S, Taiar A. 2013. Age

at menarche and its relationship to body mass index among adolescent

girls in Kuwait. BMC Public Health. 13:29.

Al-Sahab B, Ardern CI, Hamadeh MJ, Tamim H. 2010. Age at menarche in

Canada: National Longitudinal Survey. BMC Public Health 10:736.

Bogin B. 1999. Pattern of Human Growth. 2nd

Edition. Cambridge: Cambridge

Univ Pr.

[BPS] Badan Pusat Statistik. 2012. Data Agregat Kependudukan Per Kecamatan.

Jawa Tengah (ID): BPS.

Burt SCM, McCartney CR. 2010. Obesity and the pubertal transition in girls and

boys. Reproduction. 140(3): 399-410.

Etemadifar M, Janghorbani M, Shaygannejad V, Ashtari F. 2006. Prevalence of

multiple sclerosis in Isfahan, Iran. Neuroepidemiology. 27: 39-44.

Fox SI. 2002. Human Physiology. Ed ke-7. New York: Mc Graw Hill.

Gaudineau A, Ehlinger V, Vayssiere C, Jouret B, Arnaud C, Godeau E. 2010.

Factors associated with early menarche: results from the French Health

Behaviour in School-aged Children (HBSC) study. BMC Public Health.

10:175.

Garcia‐Mayor RV, Andrade MA, Rios M, Lage M, Dieguez C, Casanueva FF.

1997. Serum leptin levels in normal children: relationship to age, gender,

body mass index, pituitary‐gonadal hormones, and pubertal stage. J Clin

Endocrinol Metab. 82(9): 2849-55.

Golchin NAH, Hamzehgardeshi Z, Fakhri M, Hamzehgardeshi L. 2012. The

experience of puberty in Iranian adolescent girls: a qualitative content

analysis. BMC Public Health. 12:698.

Gubernur Jawa Tengah. Keputusan Gubernur Jawa Tengah No. 561.4/58/2012

tentang Upah Minimum pada 35 Kabupaten/Kota di Provinsi Jawa

Tengah Tahun 2013.

Hoffman WH, Barbeau P, Litaker MS, JOhnson MH, Howe CA, Gutin B. 2006.

Tanner staging of secondary characteristic and body composition, blood

pressure, and insulin in black girls. Obes Res. 13: 2195-2201.

Ifinedo P. 2006. Towards e-government in a Sub-Saharan African Country:

impediments and initiatives in Nigeria. Journal of E-Government. 3(1).

Ikaraoha CI, Mbadiwe IC, Igwe CU, Allagua DO, Mezie O, Iwo GTO, Ofori PI.

2005. Menarchial age of secondary school girls in urban and rural areas

of Rivers State Nigeria. Online J Health Allied Scs. 2: 4.

Karapanou O, Papadimitriou A. 2010. Determinants of menarche. Reproductive

Biology and Endocrinology. 8: 115.

Kawulur EIJJ, Suryobroto B, Budiarti S, Hartana A. 2010. Associations of sexual

maturation and body size of Arfak children. Hayati. 19: 124-130.

Mansfield PK, Stubbs ML. 2004. Tracking the course of menstrual life:

contributions from the society for menstrual cycle research. Women's

Health Issues. 14:174-176.

Marshall WA, Tanner JM. 1969. Variations in patterns of pubertal change in girl.

Arch Dis Child. 44: 291-303. R Development Core Team. 2012. R: A Language and Environment for Statistical

Computing. R Fondation for Statistical Computing, Vienna, Austria. ISBN

3-900051-07-0. http://www.rproject.org/. [July 30, 2013].

8

8

Rabbani et al. 2010. Assessment of pubertal development in Iranian girls. Iran J

Pediatr. 20: 160-166.

Rees M. 1993. Menarche when and why. ProQuest Biology Journals. 342: 8884

(1375).

Rosen DS. 2004. Physiologic growth and development during adolescence. Pediatrics

in Review. 25: 194.

Suhartini R. 2007. Tahap-Tahap Kematangan Seksual Perempuan di Wilayah

Bogor [skripsi]. Bogor (ID): Institut Pertanian Bogor.

Ulinnuha DF. 2008. Usia Menarke dan Perkembangan Payudara Perempuan di

Pedesaan Kabupaten Pekalongan [skripsi]. Bogor (ID): Institut Pertanian

Bogor.

Venables WN, Ripley BD. Modern Applied Statistics with S-Plus. NewYork

(US): Springer Inc.

Wilson DM, Truman CD, Thomas R, Fainsinger R, Kovacs-Burns K, Froggatt K,

Justice C. 2009. The rapidly changing location of death in Canada, 1994-

2004. Social Science Medicine. 68: 1752-1758.

9

APPENDIXES

10

Appendix 1 Informed Consent

INSTITUT PERTANIAN BOGOR

FAKULTAS MATEMATIKA DAN ILMU PENGETAHUAN

ALAM

DEPARTEMEN BIOLOGI

Gedung Fapet Lt.2 Wing 5 Jl. Agatis Bogor 16680 Telp/ Fax (0251)

622833

Hal : Permohonan Izin

Lampiran : 1 Lembar

Kepada

Yth. Orangtua/ Wali Murid

Di Tempat

Dengan hormat,

Sehubungan akan diadakannya penelitian untuk penyusunan skripsi oleh:

Nama : Arvina Oktaviani

NRP : G34090077

Institusi : Departemen Biologi, FMIPA IPB

Judul : Usia Pubertas Perempuan di Kota Purwokerto

Maka saya memohon izin untuk menjadikan putri Bapak/ Ibu sebagai

probandus (orang yang diteliti). Tujuan penelitian ini adalah mengetahui waktu

terjadinya pubertas atau maturasi seksual pada perempuan di Kota Purwokerto

berdasarkan usia menarche dan perkembangan payudara, sehingga diperoleh pola

pertumbuhan dan tahap-tahap kematangan seksual remaja perempuan khususnya

di Kota Purwokerto. Aplikasi dari penelitian ini adalah untuk menentukan status

gizi dan kesehatan anak perempuan. Prosedur penelitian ini meliputi pengambilan

data pribadi, data orang tua, dan pengamatan langsung perkembangan payudara.

Data hasil penelitian dijamin kerahasiaannya, tidak seorangpun

mengetahui kecuali peneliti dan tidak akan digunakan atau disebarluaskan selain

untuk pendidikan dan ilmu pengetahuan. Selain itu, keseluruhan data akan

disatukan untuk dianalisis sehingga data secara individu tidak jelas. Terima kasih

atas kerjasamanya.

Pernyataan persetujuan :

Sehubungan membaca penjelasan surat penelitian diatas, maka kami orang

tua/ wali murid dengan sadar dan sukarela tidak keberatan jika putri kami

dijadikan probandus penelitian selama pelaksanaan tidak menyimpang dari

maksud dan tujuan yang telah disampaikan.

Purwokerto, …………………..2013

Menyetujui

Orang Tua/ Wali Murid

10

11

Appendix 2 Example of research questionnaire

KUISIONER PENELITIAN

USIA MENARKE DI KOTA PURWOKERTO DAN SEKITARNYA

DATA PRIBADI

Nama :

Tempat & Tanggal Lahir :

Anak ke- : dari : bersaudara

Alamat lengkap :

Kelurahan :

Kecamatan :

Telepon/ HP :

Pemberian ASI sampai usia :

Penyakit (jika ada) :

Frekuensi makan per hari :

Menarche (menstruasi pertama) : sudah/ belum, jika sudah pada usia tahun

DATA ORANGTUA

Ayah

Nama :

Tempat & Tanggal Lahir/ Usia :

Suku :

Pekerjaan :

Pendidikan tertinggi :

Penyakit (jika ada) :

Tinggi Badan :

Suku kakek dari pihak ayah :

Tempat lahir/ asal kakek dari ayah :

Suku nenek dari ayah :

Tempat lahir/ asal nenek dari ayah :

Ibu

Nama :

Tempat & Tanggal Lahir/ Usia :

Suku :

Pekerjaan :

Pendidikan tertinggi :

Penyakit (jika ada) :

Tinggi Badan :

Suku kakek dari pihak ibu :

Tempat lahir/ asal kakek dari ibu :

Suku nenek dari ibu :

Tempat lahir/ asal nenek dari ibu :

Pengeluaran keluarga per bulan untuk makan (pilih salah satu):

1. n ≤ Rp500 000

2. Rp500 000 ≤ n ≤ Rp1 000 000

3. Rp1 000 000 ≤ n ≤ Rp1 500 000

4. n > Rp1 500 000

Keterangan: n= jumlah pengeluaran keluarga per bulan untuk makan

12

DATA HASIL PENGUKURAN

Tanggal :

Waktu :

Pengukur :

Probandus :

Tahap Payudara :

12

13

CURRICULUM VITAE

Writer was born on 22th

of October 1991 as the third child of five from the

parent H. Untung Suroso and Hj. Dewi Andri Astuti. In 2009, writer graduated

from SMAN 6 Jakarta and entered the Department of Biology, Faculty of

Mathematics and Natural Science, Bogor Agricultural University by USMI

selection. In 2011, writer conducted the Field Study with the research title

Serangga Pembentuk Puru in Hutan Pendidikan Gunung Walat (HPGW) and in

2012, writer conducted the Field Work on PD. Central Agro Mikro Potatoes with

the title Manajemen Seleksi dan Pemeliharaan Bibit Kentang Varietas Granola.

The writer also became laboratory assistance for Human Biology and Animal

Development on year study 2013-2014.