Fertility and Sterility · Nov 2, 2016

Associations of parity and age at first pregnancy with overall and cause-specific mortality in the Cancer Prevention Study II

By Gaudet MM, Carter BD, Hildebrand JS et al.

OBJECTIVE: To evaluate the association of parity, number of live births, and age at first birth with mortality using multivariable-adjusted Cox proportional hazards regression models. DESIGN: Observational cohort. SETTING: Not applicable. PATIENT(S): A total of 424,797 women. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): All-cause and cause-specific mortality. RESULT(S): During median follow-up of 24.93 years, 238,324 deaths occurred. Parous, compared with nulliparous, women had lower rates of all-cause (hazards ratio [HR] = 0.94, 95% confidence interval [CI] 0.93-0.96) mortality, driven by heart disease and overall cancer mortality. A linear trend was found for more births and diabetes mortality (P<.001) with having ≥6 births, compared with 2, associated with an HR of 1.28 (95% CI 1.15-1.43). Compared with age at first birth from 20-22 years, age at first birth <20 years was associated with higher mortality rates overall (HR = 1.04, 95% CI 1.02-1.06), driven by heart disease and chronic obstructive pulmonary disease mortality; whereas, ≥35 years was associated with higher overall cancer mortality (HR = 1.13, 95% CI 1.06-1.20). CONCLUSION(S): Although parity was associated with a slight reduction in rates of all-cause mortality resulting in a minimal impact on average lifespan, the higher diabetes mortality in grand multiparous women might warrant continuous monitoring, particularly for abnormal glucose metabolism, among these women.

doi.org/10.1016/j.fertnstert.2016.09.043Open accessPubMed 27816232Populations