Shiori Otsuki1, Eiko Saito2, Norie Sawada3, Sarah K Abe4, Akihisa Hidaka3, Taiki Yamaji3, Taichi Shimazu3, Atsushi Goto3, Motoki Iwasaki3, Hiroyasu Iso5, Tetsuya Mizoue6, Kenji Shibuya4, Manami Inoue7, Shoichiro Tsugane3. 1. Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan. 2. Division of Cancer Statistics Integration, Center for Cancer Control & Information Services, National Cancer Center, Tokyo, Japan. 3. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan. 4. Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 5. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. 6. Department of Epidemiology and Prevention, Center for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, Japan. 7. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan. Electronic address: mnminoue@ncc.go.jp.
Abstract
PURPOSE: We investigated the association between reproductive history and mortality from all and major causes among Japanese women. METHODS: A large-scale population-based cohort study in Japan included 40,149 eligible women aged 40-69 years in 1990-1994. A total of 4788 deaths were reported during follow-up (average 20.9 years). A Cox proportional hazards regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CI) for all-cause and major causes of mortality, adjusting for potential confounders. RESULTS: Inverse associations with all-cause mortality were found in parous women (0.74 [0.67-0.82]), women with two or three births compared with a single birth (2 births: 0.88 [0.78-0.99]; 3 births: 0.83 [0.74-0.94]), parous women who breastfed (0.81 [0.75-0.87]), women who were older at menopause (0.88 [0.80-0.97]; p-trend: <0.01), and women who had a longer fertility span (0.85 [0.76-0.95]; p-trend: <0.01). A positive association was seen between all-cause mortality and later age at first birth (≥30 years) than early childbearing (≤22 years). CONCLUSIONS: Our study suggests that parous, two or three births, breastfeeding, late age at menopause, and longer reproductive span are associated with lower risk of all-cause of mortality.
PURPOSE: We investigated the association between reproductive history and mortality from all and major causes among Japanese women. METHODS: A large-scale population-based cohort study in Japan included 40,149 eligible women aged 40-69 years in 1990-1994. A total of 4788 deaths were reported during follow-up (average 20.9 years). A Cox proportional hazards regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CI) for all-cause and major causes of mortality, adjusting for potential confounders. RESULTS: Inverse associations with all-cause mortality were found in parous women (0.74 [0.67-0.82]), women with two or three births compared with a single birth (2 births: 0.88 [0.78-0.99]; 3 births: 0.83 [0.74-0.94]), parous women who breastfed (0.81 [0.75-0.87]), women who were older at menopause (0.88 [0.80-0.97]; p-trend: <0.01), and women who had a longer fertility span (0.85 [0.76-0.95]; p-trend: <0.01). A positive association was seen between all-cause mortality and later age at first birth (≥30 years) than early childbearing (≤22 years). CONCLUSIONS: Our study suggests that parous, two or three births, breastfeeding, late age at menopause, and longer reproductive span are associated with lower risk of all-cause of mortality.
Authors: Mette W Christensen; David L Keefe; Fang Wang; Christine S Hansen; Isaac J Chamani; Carolyn Sommer; Mette Nyegaard; Palle D Rohde; Anders L Nielsen; Jonas Bybjerg-Grauholm; Ulrik S Kesmodel; Ulla B Knudsen; Kirstine Kirkegaard; Hans Jakob Ingerslev Journal: J Assist Reprod Genet Date: 2021-10-01 Impact factor: 3.412
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