标题：Childbearing factors in relation to all-cause and cause-specific mortality in a follow-up study of U.S. Black women

作者：Li, S. Rosenberg, L. Wise, L. Palmer, J.

网址:http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=emed11&AN=71079469

求助者：云

• 求助时间：2015/9/10 22:05:03
• 文献摘要：

Background: There has been a long-term debate about whether reproductive history influences mortality later in life. Previous studies have been inconclusive. Methods: We prospectively investigated the relation of parity, age at first birth, age at last birth, and lactation to all-cause and cause-specific mortality. We followed 57,757 U.S. black women aged 21-69 years at enrollment in the Black Women´s Health Study (BWHS) from 1995 to 2008. Multivariable Cox proportional hazard models were used to estimate mortality rate ratios (MRR) and 95% confidence intervals (CI). Results: Of the 2,455 deaths identified during 716,580 person years of follow-up, 922 were due to cancer, 618 to cardiovascular diseases, and 915 to other causes. Among women under age 55, high parity was associated with increased allcause mortality (MRR = 1.65, 95% CI 1.25-2.18, for parity >4 vs. 1, Ptrend < 0.001), with a 53% increase in cancer mortality and a 131% increase in cardiovascular mortality; late age at last birth was associated with lower all-cause mortality (MRR = 0.63, 95% CI 0.46-0.87, for last birth at age >35 vs. <25 years, P-trend = 0.01), with a 41% decrease in cardiovascular mortality and 33% decrease in other-cause mortality. In contrast, among women >55 years, neither parity nor age at first birth was associated with all-cause or cause-specific mortality. Conclusions: Our data support the hypothesis that somatic resources used for reproduction may compete with resources required for longevity. Among parous women, late age at last birth may be a marker of reduced reproductive or somatic aging. For women who survive beyond 55 years, the impact of reproductive history on all-cause or cause-specific mortality is negligible.