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Zhou L, Chen X, Zhang G, Sui Y, Hou L, Hu F, Xia X, Luo S, Peng X, Yue J, Dong B, Dong B, Liu X. Associations of parity and cognitive decline, depression, and chronic comorbidity in West China: Results from WCHAT study. Int J Gynaecol Obstet 2024. [PMID: 38967049 DOI: 10.1002/ijgo.15754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 06/06/2024] [Accepted: 06/14/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE To investigate the associations between parity (the number of offspring a female has borne) and cognitive function, depression, and chronic comorbidity in Western China. METHODS A total of 846 women aged 50-55 years were included in the current analysis. Cognitive status was measured using a 10-item short portable mental status questionnaire (SPMSQ). Depressive symptoms were assessed using the 15-item geriatric depression scale (GDS-15). Other characteristics were self-reported. The associations between parity and cognitive decline, depression, and chronic comorbidity were analyzed using univariable and multivariable models. Multivariable models were adjusted for age, ethnic group, occupation, marital status, educational level, lifestyle factors, and sleeping time. RESULTS Among the enrolled women, 26.71% were either childless or had one child, 47.40% had two children, 18.32% had three children, and 7.57% had ≥4 children. Compared to women with low parity, women with two or more children exhibited a higher risk of cognitive decline. Moreover, having four or more children was significantly associated with depression and chronic comorbidity. After adjusting covariates, women with three or more children exhibited a higher risk of cognitive decline than those with low parity. However, high parity was not significantly associated with depression or chronic comorbidity after adjustment for covariates. CONCLUSION Our study showed that ≥3 children was associated with cognitive decline in women. Longitudinal studies are needed to evaluate this conclusion and to investigate the mechanisms involved. More importantly, families and societies should pay more attention to women's long-term health outcomes related to fertility.
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Affiliation(s)
- Lixing Zhou
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiaoyan Chen
- Zigong Mental Health Center, Zigong, Sichuan Province, China
| | - Gongchang Zhang
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, Sichuan Province, China
| | - Yunpeng Sui
- Plastic and Aesthetic Department, West China Tianfu Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Lisha Hou
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, Sichuan Province, China
| | - Fengjuan Hu
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, Sichuan Province, China
| | - Xin Xia
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, Sichuan Province, China
| | - Shuyue Luo
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, Sichuan Province, China
| | - Xuchao Peng
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, Sichuan Province, China
| | - Jirong Yue
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, Sichuan Province, China
| | - Biao Dong
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Birong Dong
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiaolei Liu
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, Sichuan Province, China
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2
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Meitern R, Hõrak P. Survival costs and benefits of reproduction: A register-based study in 20th century Estonia. Ann N Y Acad Sci 2024; 1535:137-148. [PMID: 38536396 DOI: 10.1111/nyas.15127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2024]
Abstract
Patterns of individual variation in lifespan and senescence depend on the associations between parental survival and reproductive rates. We studied the associations between parity and survival among 579,271 Estonians born between 1905 and 1945 and in a cohort with a completed lifespan born in 1905-1927. For this cohort, selection for increased lifespan operated on both sexes, but it was stronger in men than in women. However, the median lifespan increased between the subsequent cohorts in women but stagnated in men. Selection for longer lifespan was caused by the below-average lifespan of individuals with no or single offspring. Despite a general positive selection for lifespan, survival costs of reproduction were also detected among a relatively small proportion of individuals with high parities, as mothers of two and fathers of two and three children had the highest median lifespans. Fathers of more than six children had better survival than fathers of few children in their reproductive age, but this association reversed after age 70. The reversal of this association between survival and parity at old age indicates that relative mortality risks between those with lower versus higher parities change across ages, as predicted by the antagonistic pleiotropy theory of aging.
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Affiliation(s)
| | - Peeter Hõrak
- Department of Zoology, University of Tartu, Tartu, Estonia
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Ryan CP, Lee NR, Carba DB, MacIsaac JL, Lin DTS, Atashzay P, Belsky DW, Kobor MS, Kuzawa CW. Pregnancy is linked to faster epigenetic aging in young women. Proc Natl Acad Sci U S A 2024; 121:e2317290121. [PMID: 38588424 PMCID: PMC11032455 DOI: 10.1073/pnas.2317290121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/13/2024] [Indexed: 04/10/2024] Open
Abstract
A central prediction of evolutionary theory is that energy invested into reproduction comes at the expense of somatic maintenance and repair, accelerating biological aging. Supporting this prediction are findings that high fertility among women predicts shorter lifespan and poorer health later in life. However, biological aging is thought to begin before age-related health declines, limiting the applicability of morbidity and mortality for studying the aging process earlier in life. Here, we examine the relationship between reproductive history and biological aging in a sample of young (20 to 22yo) men and women from the Cebu Longitudinal Health and Nutrition Survey, located in the Philippines (n = 1,735). We quantify biological aging using six measures, collectively known as epigenetic clocks, reflecting various facets of cellular aging, health, and mortality risk. In a subset of women, we test whether longitudinal changes in gravidity between young and early-middle adulthood (25 to 31yo) are associated with changes in epigenetic aging during that time. Cross-sectionally, gravidity was associated with all six measures of accelerated epigenetic aging in women (n = 825). Furthermore, longitudinal increases in gravidity were linked to accelerated epigenetic aging in two epigenetic clocks (n = 331). In contrast, the number of pregnancies a man reported fathering was not associated with epigenetic aging among same-aged cohort men (n = 910). These effects were robust to socioecological, environmental, and immunological factors, consistent with the hypothesis that pregnancy accelerates biological aging and that these effects can be detected in young women in a high-fertility context.
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Affiliation(s)
- Calen P. Ryan
- Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY10032
| | - Nanette R. Lee
- USC-Office of Population Studies Foundation, University of San Carlos, Talamban, Cebu City6000, Philippines
| | - Delia B. Carba
- USC-Office of Population Studies Foundation, University of San Carlos, Talamban, Cebu City6000, Philippines
| | - Julie L. MacIsaac
- BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BCV5Z 4H4, Canada
| | - David T. S. Lin
- BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BCV5Z 4H4, Canada
| | - Parmida Atashzay
- BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BCV5Z 4H4, Canada
| | - Daniel W. Belsky
- Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY10032
- Department of Epidemiology, Columbia University Mailman School of Public Health, Columbia University, New York, NY10032
- Child and Brain Development Program, Canadian Institute for Advanced Research, TorontoONM5G 1M1, Canada
| | - Michael S. Kobor
- BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BCV5Z 4H4, Canada
- Child and Brain Development Program, Canadian Institute for Advanced Research, TorontoONM5G 1M1, Canada
- Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
- Centre for Molecular Medicine and Therapeutics, Vancouver, BCV5Z 4H4, Canada
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Liao GZ, Huang Y, Guan JY, Luo MQ, Huang LY, Feng JY, Zhang YH, Zhang J. Comprehensively evaluating the relationships between marital status and other family factors with cardiovascular disease and long-term overall mortality in the elderly: a study of 48 510 Chinese individuals. Postgrad Med J 2024:qgae053. [PMID: 38598956 DOI: 10.1093/postmj/qgae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/14/2024] [Accepted: 03/27/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Marital status is associated with cardiovascular disease (CVD) incidence and overall mortality, yet limited research on this topic in elderly individuals is available. Our aim was to comprehensively assess the impact of marital status and other family factors on CVD incidence and long-term mortality among elderly people. METHODS Data from the Chinese Longitudinal Healthy Longevity Survey (2002/2005/2008-2018) for participants aged ≥60 years were analysed. A cross-sectional study initially examined the correlation between spouses, offspring, living arrangements, and CVD using logistic regression. Subsequently, a retrospective cohort study investigated the long-term associations of these factors with overall mortality via Kaplan-Meier and Cox regression analyses. RESULTS The study involved 48 510 subjects (average age: 87 years). The cross-sectional analysis revealed a correlation between living with a spouse and an increased incidence of heart disease (adjusted OR 1.27, 95% CI 1.04-1.55) and cerebrovascular disease/stroke (adjusted OR 1.26, 95% CI 1.11-1.42). According to the retrospective cohort analysis, living with a spouse significantly reduced overall mortality (adjusted HR 0.84, 95% CI 0.80-0.87), irrespective of marital relationship quality. Conversely, living with offspring (adjusted HR 1.12, 95% CI 1.08-1.16), having more children (adjusted Pnonlinearity = 0.427) or cohabitants (adjusted Pnonlinearity < 0.0001) were associated with increased overall mortality. CONCLUSION In the elderly population, being married and living with a spouse were not significantly associated with a decrease in CVD incidence but were associated with a reduction in long-term overall mortality. Living with offspring, having more children, or having a larger family size did not replicate the protective effect but indicated greater overall mortality.
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Affiliation(s)
- Guang-Zhi Liao
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 10037, China
| | - Yan Huang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 10037, China
| | - Jing-Yuan Guan
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 10037, China
| | - Man-Qing Luo
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 10037, China
| | - Li-Yan Huang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 10037, China
| | - Jia-Yu Feng
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 10037, China
| | - Yu-Hui Zhang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 10037, China
| | - Jian Zhang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 10037, China
- Key Laboratory of Clinical Research for Cardiovascular Medications, National Health Committee, Beijing 10037, China
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Uccheddu D, Emery T, Gauthier AH, Steverink N. Gendered work-family life courses and late-life physical functioning: A comparative analysis from 28 European countries. ADVANCES IN LIFE COURSE RESEARCH 2022; 53:100495. [PMID: 36652213 DOI: 10.1016/j.alcr.2022.100495] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 06/09/2022] [Accepted: 06/20/2022] [Indexed: 06/17/2023]
Abstract
Combining work and family roles can have beneficial consequences on health but could also result in chronic stress and adverse health outcomes at older ages. This study aimed to examine combined employment, parenthood, and partnership histories of men and women during the childbearing period (ages 15-49), and to investigate the links of these work and family roles with physical functioning later in life. We used data from the Survey of Health, Ageing and Retirement in Europe (SHARE) with retrospective information on employment, parenthood, and partnership histories for 18,057 men and 20,072 women (n = 38,129) living in 28 different countries belonging to six European welfare clusters. We applied multichannel sequence analysis (MCSQA) and hierarchical clustering to group work-family trajectories into 12 clusters for men and 15 clusters for women. We assessed the association between work-family life courses and grip strength by estimating multivariable linear regression models. Delayed work and family transitions, unstable employment, and the absence of combinations of work and family roles between age 15 and 49 were associated with weaker grip strength in later life for both men and women. Results differed by gender and were framed by the welfare context in which gendered work and family responsibilities unfold across individual life courses. The findings make an important contribution to the domain of gender and health in later life and stress the need to engage more with issues related to the mechanisms linking work and family trajectories to poor health in later life.
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Affiliation(s)
- Damiano Uccheddu
- University of Louvain (UCLouvain), Louvain-la-Neuve, Belgium; Netherlands Interdisciplinary Demographic Institute (NIDI-KNAW), The Hague, the Netherlands; Department of Sociology, University of Groningen, Groningen, the Netherlands.
| | - Tom Emery
- Department of Public Administration and Sociology (DPAS), Erasmus School of Social and Behavioural Sciences (ESSB), Erasmus University Rotterdam, Rotterdam, the Netherlands.
| | - Anne H Gauthier
- Netherlands Interdisciplinary Demographic Institute (NIDI-KNAW), The Hague, the Netherlands; Department of Sociology, University of Groningen, Groningen, the Netherlands.
| | - Nardi Steverink
- Department of Sociology, University of Groningen, Groningen, the Netherlands; Department of Health Psychology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands.
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Yu C, Liang H, Wang B, Liang F, Liu E, Xiang N. The association between reproductive history and the multidimensional health of older adults in rural China and its gender differences: Evidence from the Chinese longitudinal healthy longevity survey. Front Public Health 2022; 10:952671. [PMID: 35968445 PMCID: PMC9364953 DOI: 10.3389/fpubh.2022.952671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundFew studies have examined the association between reproductive history and the multidimensional health of older adults with more diverse reproductive histories and poorer health status in rural China. The purpose of this study is to explore the effect of parity, sex ratio of children and late childbearing on multidimensional health and its gender differences.MethodsThe analytical sample consisted of 3,377 older adults in rural China who participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2018. Linear regression models were applied to estimate the relationship between reproductive history and multidimensional health, with separate models for each indicator of health outcomes.ResultsOlder adults in rural areas with greater parity were more likely to have better cognitive function (β = 0.409, 95% CI: 0.255–0.563), fewer Activities of Daily Living (ADL) limitations (β = −0.085, 95% CI: −0.137 to −0.034) and symptoms of depression (β = −0.396, 95% CI: −0.577 to −0.216). The social mechanism of intergenerational support from children later in life partly explained the positive effect of parity. Late childbearing had negative effects on cognitive function (β = −1.220, 95% CI: −1.895 to −0.545), ADL (β = 0.253, 95% CI: 0.028–0.478) and symptoms of depression (β = 1.025, 95% CI: 0.237–1.812). Women were more likely to be influenced by the positive effect of parity; the association between late childbearing and health was only significant in the male group.ConclusionsParity and late childbearing are associated with cognitive function, activities of daily living, and symptoms of depression in the older adults in rural China. Older adults with more children might be in better health, and this finding is especially significant in women. However, late childbearing had a negative effect on multidimensional health, especially for men. The social mechanism and gender differences between reproductive history and health need to be further explored.
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Affiliation(s)
- Changyong Yu
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Hang Liang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Boyu Wang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Fei Liang
- Policy Research Center, Ministry of Civil Affairs of China, Beijing, China
| | - Erpeng Liu
- Institute of Income Distribution and Public Finance, School of Public Finance and Taxation, Zhongnan University of Economics and Law, Wuhan, China
- *Correspondence: Erpeng Liu
| | - Nan Xiang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
- Nan Xiang
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7
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Zhou WL, Zhang S, Yang HL, Gu YW, Yao YD, Wu YY, Zhang SQ. Impact of fertility on the longevity of older rural Chinese women: an analysis of a longitudinal survey. BMC Public Health 2022; 22:682. [PMID: 35392851 PMCID: PMC8991657 DOI: 10.1186/s12889-022-13039-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 03/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background This study evaluates the impact of fertility during the childbearing period on the longevity of older rural Chinese women and verifies whether any trade-off exists between women’s longevity and their number of children to provide empirical evidence for improving health intervention policies and formulating active fertility policies in low-fertility countries. Methods Based on the data of the deaths of 1623 older adults aged 65 and above during 2014–2018 in the Chinese Longitudinal Healthy Longevity Survey, this study explores the relationship between the number of children born and older rural women’s longevity using the ordinary least squares method. Furthermore, the impact of fertility on the longevity of men and women in rural and urban areas, along with other reproductive behaviours on older rural women’s longevity, were analysed. Results There was a significant negative correlation between the number of children born and women’s longevity (β = − 0.555, p < 0.05). Additionally, their longevity exhibited a decreasing trend with having birthed more sons and an increasing trend with more daughters. Age at first and last births had a significant positive relationship with rural women’s longevity; however, the effect of fertility on the longevity of older rural and urban men and older urban women was not significant. Conclusions It is confirmed that there is a trade-off between fertility and longevity for rural women in China. Future research should focus on compensating for the decline in female longevity caused by the number of children born and promote the concept of a healthy pregnancy, scientific nurture, and gender equality in fertility.
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Affiliation(s)
- Wan-Li Zhou
- School of Finance and Public Administration, Hubei University of Economics, 8 Yangqiaohu Avenue, Canglong Island Development Zone, Wuhan, China
| | - Shuo Zhang
- School of Public Administration, Zhongnan University of Economics and Law, 182 Nanhu Avenue, Donghu New Technology Development Zone, Wuhan, China
| | - Hua-Lei Yang
- School of Public Administration, Zhongnan University of Economics and Law, 182 Nanhu Avenue, Donghu New Technology Development Zone, Wuhan, China
| | - Ying-Wen Gu
- School of Public Administration, Zhongnan University of Economics and Law, 182 Nanhu Avenue, Donghu New Technology Development Zone, Wuhan, China.
| | - Yi-Dan Yao
- School of Public Administration, Zhongnan University of Economics and Law, 182 Nanhu Avenue, Donghu New Technology Development Zone, Wuhan, China
| | - Yuan-Yang Wu
- School of Public Administration, Zhongnan University of Economics and Law, 182 Nanhu Avenue, Donghu New Technology Development Zone, Wuhan, China
| | - Si-Qing Zhang
- School of Public Administration, Zhongnan University of Economics and Law, 182 Nanhu Avenue, Donghu New Technology Development Zone, Wuhan, China
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Ryan CP, Jones MJ, Edgar RD, Lee NR, Kobor MS, McDade TW, Kuzawa CW. Immune cell type and DNA methylation vary with reproductive status in women: possible pathways for costs of reproduction. Evol Med Public Health 2022; 10:47-58. [PMID: 35169479 PMCID: PMC8841013 DOI: 10.1093/emph/eoac003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 01/11/2022] [Indexed: 12/13/2022] Open
Abstract
Background Consistent with evolutionarily theorized costs of reproduction (CoR), reproductive history in women is associated with life expectancy and susceptibility to certain cancers, autoimmune disorders and metabolic disease. Immunological changes originating during reproduction may help explain some of these relationships. Methodology To explore the potential role of the immune system in female CoR, we characterized leukocyte composition and regulatory processes using DNA methylation (DNAm) in a cross-sectional cohort of young (20–22 years old) women differing in reproductive status. Results Compared to nulliparity, pregnancy was characterized by differential methylation at 828 sites, 96% of which were hypomethylated and enriched for genes associated with T-cell activation, innate immunity, pre-eclampsia and neoplasia. Breastfeeding was associated with differential methylation at 1107 sites (71% hypermethylated), enriched for genes involved in metabolism, immune self-recognition and neurogenesis. There were no significant differences in DNAm between nulliparous and parous women. However, compared to nullipara, pregnant women had lower proportions of B, CD4T, CD8T and natural killer (NK) cells, and higher proportions of granulocytes and monocytes. Monocyte counts were lower and NK counts higher among breastfeeding women, and remained so among parous women. Implications Our findings point to widespread differences in DNAm during pregnancy and lactation. These effects appear largely transient, but may accumulate with gravidity become detectable as women age. Nulliparous and parous women differed in leukocyte composition, consistent with more persistent effects of reproduction on cell type. These findings support transient (leukocyte DNAm) and persistent (cell composition) changes associated with reproduction in women, illuminating potential pathways contributing to CoR. Lay Summary: Evolutionary theory and epidemiology support costs of reproduction (CoR) to women’s health that may involve changes in immune function. We report differences in immune cell composition and gene regulation during pregnancy and breastfeeding. While many of these differences appear transient, immune cell composition may remain, suggesting mechanisms for female CoR.
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Affiliation(s)
- Calen P Ryan
- Department of Anthropology, Northwestern University, Evanston, IL 60208, USA
| | - Meaghan J Jones
- Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.,Children's Hospital Research Institute, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
| | | | - Nanette R Lee
- University of San Carlos Office of Population Studies Foundation Inc., Cebu City 6000, Philippines
| | - Michael S Kobor
- BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC V5Z 4H4, Canada.,Child and Brain Development Program, Canadian Institute for Advanced Research, Toronto, ON M5G 1Z8, Canada
| | - Thomas W McDade
- Department of Anthropology, Northwestern University, Evanston, IL 60208, USA.,Child and Brain Development Program, Canadian Institute for Advanced Research, Toronto, ON M5G 1Z8, Canada.,Institute for Policy Research, Northwestern University, Evanston, IL 60208, USA
| | - Christopher W Kuzawa
- Department of Anthropology, Northwestern University, Evanston, IL 60208, USA.,Institute for Policy Research, Northwestern University, Evanston, IL 60208, USA
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Costanian C, Farah R, Salameh R, Meisner BA, Aoun Bahous S, Sibai AM. The Influence of Female Reproductive Factors on Longevity: A Systematized Narrative Review of Epidemiological Studies. Gerontol Geriatr Med 2022; 8:23337214221138663. [DOI: 10.1177/23337214221138663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/22/2022] [Accepted: 10/27/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose: This systematized review presents a synthesis of epidemiological studies that examine the association between female reproductive factors and longevity indicators. Methods: A comprehensive literature search was conducted using four bibliographic databases: OVID Medline, Web of Science, PubMed, and Google Scholar, including English language articles published until March 2022. Results from the search strategy yielded 306 articles, 37 of which were included for review based on eligibility criteria. Results were identified within the following nine themes: endogenous androgens and estrogens, age at first childbirth, age at last childbirth, parity, reproductive lifespan, menopause-related factors, hormone therapy use, age at menarche, and offspring gender. Results: Evidence that links reproductive factors and long lifespan is limited. Several female reproductive factors are shown to be significantly associated with longevity, yet findings remain inconclusive. The most consistent association was between parity (fertility and fecundity) and increased female lifespan. Age at first birth and parity were consistently associated with increased longevity. Associations between age at menarche and menopause, premature menopause, reproductive lifespan, offspring gender and longevity are inconclusive. Conclusion: There is not enough evidence to consider sex a longevity predictor. To understand the mechanisms that predict longevity outcomes, it is imperative to consider sex-specific within-population differences.
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Affiliation(s)
| | | | | | | | | | - Abla M. Sibai
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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10
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Orr J, Kenny RA, McGarrigle CA. Higher Parity Is Associated With Lower Mortality in a European Population of Women With High Fertility: Results From Ireland. J Gerontol A Biol Sci Med Sci 2021; 76:1571-1578. [PMID: 33367528 DOI: 10.1093/gerona/glaa323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Indexed: 11/13/2022] Open
Abstract
Research has often found a U- or J-shaped association between parity and mortality. Many researchers have suggested repeated pregnancy, childbirth, and lactation taxes the body beyond a certain parity level. Available research has concentrated on populations with controlled fertility or historic populations. Ireland presents an opportunity to explore these associations in a modern sample with high fertility. We use data from the Irish Longitudinal Study on Ageing (TILDA) to test whether parity is associated with mortality in women aged 50 years or over (n = 4177). We use Cox proportional hazards models to model survival and adjust for demographics and early life circumstances. We test whether a number of health characteristics mediate these effects. Models were also stratified by birth cohort to test possible cohort effects. Higher parity was associated with lower risk of mortality, even after adjustment for early life and socioeconomic circumstances. This effect was not mediated by current health characteristics. The effects were largely driven by those born between 1931 and 1950. Increasing parity is associated with decreasing mortality risk in this sample. The effects of parity could not be explained through any of the observed health characteristics. These findings are in contrast to much of the literature on this question in similar populations. Lack of fertility control in Ireland may have "selected" healthier women into high parity. Social explanations for these associations should be further explored.
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Affiliation(s)
- Joanna Orr
- The Irish Longitudinal Study on Ageing (TILDA), Lincoln Gate, Trinity College Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Lincoln Gate, Trinity College Dublin, Ireland.,Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Christine A McGarrigle
- The Irish Longitudinal Study on Ageing (TILDA), Lincoln Gate, Trinity College Dublin, Ireland
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11
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Kim J. The Relationship Between Children's Gender Composition and Parents' All-Cause Mortality Among Older Adults in Korea. J Appl Gerontol 2021; 41:754-762. [PMID: 34009047 DOI: 10.1177/07334648211012122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Using data from the Korean Longitudinal Study of Aging (N = 3,356 participants aged 65 or older) and estimating Cox proportional hazard regression models, this study investigated the association between gender composition of children and parents' mortality risk. This study showed that compared with having both daughters and sons, having exclusively daughters (but not exclusively sons) was associated with higher mortality risk. This association, however, was significant for mothers, but not for fathers. To shed light on source of this association, this study distinguished between mothers with only daughters who receive and do not receive regular financial support from children. Results showed that mothers had elevated mortality risk only if they do not receive regular financial support from their children. Traditional caregiving roles of sons for older parents in Korea may lead to a mortality disadvantage among mothers of daughters vis-à-vis a reduction in financial assistance from children.
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Affiliation(s)
- Jinho Kim
- Korea University, Seoul, Republic of Korea.,Center for Demography of Health and Aging, Madison, WI, USA
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12
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Shirazi TN, Hastings WJ, Rosinger AY, Ryan CP. Parity predicts biological age acceleration in post-menopausal, but not pre-menopausal, women. Sci Rep 2020; 10:20522. [PMID: 33239686 PMCID: PMC7689483 DOI: 10.1038/s41598-020-77082-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/27/2020] [Indexed: 12/26/2022] Open
Abstract
Understanding factors contributing to variation in ‘biological age’ is essential to understanding variation in susceptibility to disease and functional decline. One factor that could accelerate biological aging in women is reproduction. Pregnancy is characterized by extensive, energetically-costly changes across numerous physiological systems. These ‘costs of reproduction’ may accumulate with each pregnancy, accelerating biological aging. Despite evidence for costs of reproduction using molecular and demographic measures, it is unknown whether parity is linked to commonly-used clinical measures of biological aging. We use data collected between 1999 and 2010 from the National Health and Nutrition Examination Survey (n = 4418) to test whether parity (number of live births) predicted four previously-validated composite measures of biological age and system integrity: Levine Method, homeostatic dysregulation, Klemera–Doubal method biological age, and allostatic load. Parity exhibited a U-shaped relationship with accelerated biological aging when controlling for chronological age, lifestyle, health-related, and demographic factors in post-menopausal, but not pre-menopausal, women, with biological age acceleration being lowest among post-menopausal women reporting between three and four live births. Our findings suggest a link between reproductive function and physiological dysregulation, and allude to possible compensatory mechanisms that buffer the effects of reproductive function on physiological dysregulation during a woman’s reproductive lifespan. Future work should continue to investigate links between parity, menopausal status, and biological age using targeted physiological measures and longitudinal studies.
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Affiliation(s)
- Talia N Shirazi
- Department of Anthropology, Pennsylvania State University, 421 Carpenter Building, University Park, PA, 16802, USA.
| | - Waylon J Hastings
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Asher Y Rosinger
- Department of Anthropology, Pennsylvania State University, 421 Carpenter Building, University Park, PA, 16802, USA.,Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Calen P Ryan
- Department of Anthropology, Northwestern University, Evanston, IL, USA
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13
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Ellwardt L, Hank K, Mendes de Leon CF. Grandparenthood and risk of mortality: Findings from the Health and Retirement Study. Soc Sci Med 2020; 268:113371. [PMID: 32980678 DOI: 10.1016/j.socscimed.2020.113371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/12/2020] [Accepted: 09/13/2020] [Indexed: 11/25/2022]
Abstract
Grandparenthood constitutes a significant role for older adults and may have important health implications. Our study examines the grandparenthood-mortality nexus, controlling for an array of potentially confounding variables. Longitudinal survey data from the Health and Retirement Study (HRS) were used, comprising twelve biennial waves from 1992 to 2014 with linked data on vital status derived from the National Death Index. The sample included 27,463 participants aged ≥51 years with at least one child. Cox proportional hazard models tested the association between grandparenthood and mortality risk with adjustment for socio-demographic variables, for social variables including characteristics of and contact with children, and for health variables, including measures of general, functional and mental health. Grandparenthood overall was unassociated with mortality risk in both women and men. However, the subpopulation of younger, partnered grandmothers with a larger number of grandchildren tended to exhibit a substantial increase in mortality risk as compared to women without grandchildren.
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Affiliation(s)
- Lea Ellwardt
- University of Cologne, Institute of Sociology and Social Psychology, Albert Magnus Platz, 50935, Cologne, Germany.
| | - Karsten Hank
- University of Cologne, Institute of Sociology and Social Psychology, Albert Magnus Platz, 50935, Cologne, Germany
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14
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Einiö E, Hiltunen E, Martikainen P, Korhonen K. Men's age at first birth and alcohol-related morbidity and mortality among siblings. Drug Alcohol Depend 2020; 209:107942. [PMID: 32145663 DOI: 10.1016/j.drugalcdep.2020.107942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/29/2020] [Accepted: 02/25/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Men's age at first birth may negatively or positively affect alcohol-related morbidity and mortality, although little evidence is available. METHODS We used register data of over 22,000 brothers to analyze the associations between age at first birth and alcohol-related morbidity and mortality from the age of 35 until the age of 60 or 72. We employed conventional Cox models and inter-sibling models, which allowed adjustment for unobserved social and genetic characteristics shared by brothers. RESULTS The findings show that men's age at first birth was inversely associated with alcohol-related morbidity and mortality, independent of unobserved characteristics shared by brothers and of observed demographic confounders. Men who had their first child late at 35-45 years experienced lower alcohol-related morbidity and mortality (hazard ratio (HR) = 0.57, 95 % confidence interval (CI) = 0.43, 0.75) than men who had their first child at 25-29. Men who had their first child before age 20 had the highest morbidity and mortality among all fathers (HR = 1.36, 95 % CI = 1.09, 1.69), followed by men who had their child at 20-24 (HR = 1.12, 95 % CI = 1.00, 1.25). CONCLUSIONS The results imply that the inverse association between men's age at first birth and alcohol-related morbidity and mortality is not driven by familial characteristics.
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Affiliation(s)
- Elina Einiö
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, P.O. Box 18, FIN-00014 Helsinki, Finland; London School of Economics and Political Science, Department of Social Policy, London WC2A 2AE, United Kingdom.
| | - Elina Hiltunen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, P.O. Box 18, FIN-00014 Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, P.O. Box 18, FIN-00014 Helsinki, Finland; Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Kaarina Korhonen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, P.O. Box 18, FIN-00014 Helsinki, Finland
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15
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Sironi M, Ploubidis GB, Grundy EM. Fertility History and Biomarkers Using Prospective Data: Evidence From the 1958 National Child Development Study. Demography 2020; 57:529-558. [PMID: 32133595 PMCID: PMC7162827 DOI: 10.1007/s13524-020-00855-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Research on the later-life health implications of fertility history has predominantly considered associations with mortality or self-reported indicators of health. Most of this previous research has either not been able to account for selection factors related to both early-life and later-life health or has had to rely on retrospectively reported accounts of childhood circumstances. Using the 1958 National Child Development Study, and in particular the biomedical survey conducted in 2002-2003, we investigate associations between fertility histories (number of children and age at first and at last birth) and biomarkers for cardiometabolic risk and respiratory function in midlife among both men and women. Results from models that adjusted for a very wide range of childhood factors, including early-life socioeconomic position, cognitive ability, and mental health, showed weak associations between parity and biomarkers. However, we found an inverse association between age at first birth and biomarkers indicative of worse cardiometabolic health, with poorer outcomes for those with very young ages at entry to parenthood and increasingly better outcomes for those becoming parents at older ages. A very young age at last birth was also associated with less favorable biomarker levels, especially among women. Results highlight the value of prospectively collected data and the availability of biomarkers in studies of life course determinants of health in midlife and later.
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Affiliation(s)
- Maria Sironi
- Department of Social Science, University College London, 55-59 Gordon Square, London, WC1H 0NU United Kingdom
| | - George B. Ploubidis
- Department of Social Science, University College London, 55-59 Gordon Square, London, WC1H 0NU United Kingdom
- UCL Center for Longitudinal Studies, University College London, 55-59 Gordon Square, London, WC1H 0NU United Kingdom
| | - Emily M. Grundy
- Institute for Social & Economic Research, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ United Kingdom
- Centre for Fertility and Health, Norwegian Institute for Public Health, Lovisenberggata 8, 0456 Oslo, Norway
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16
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Abstract
Understanding the association between fertility histories and health later in life is necessary in the context of ageing societies. Past literature has generally found a U-shaped relationship between parity, age at first birth, and several health-related outcomes. However, these findings differed to some extent depending on the country under analysis and on the measures of health considered. As such, using wave 3 (2008-2009) and 5 (2013) of the Survey of Health, Ageing and Retirement in Europe (SHARE), this work aimed to answer the question: "Are fertility histories associated with the presence of chronic conditions later in life in Europe?" The analysis included 11 European countries and compared results using two different measures of chronic conditions: self-reported chronic or long-term illness and chronic diseases diagnosed by a doctor. Results showed that age at first birth is more relevant than parity for health outcomes at older ages. Moreover, in socio-democratic and continental countries, the association between fertility and chronic conditions-in particular between age at first birth and long-term illnesses-is statistically significant among women, but not among men. Finally, the association between fertility history and health was similar when using self-reported measures and chronic diseases diagnosed by a doctor.
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Affiliation(s)
- Maria Sironi
- Department of Social Science, University College London, 20 Bedford Way, London, WC1H 0AL UK
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17
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Minami Y, Nishino Y, Kawai M, Tada H, Kanemura S, Miyashita M, Ishida T, Kakugawa Y. Reproductive history and breast cancer survival: a prospective patient cohort study in Japan. Breast Cancer 2019; 26:687-702. [PMID: 30993643 DOI: 10.1007/s12282-019-00972-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 04/05/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Reproductive factors may influence breast cancer progression and patient survival; however, evidence has been limited. METHODS The associations of reproductive factors with tumor characteristics and patient survival were analyzed among 1468 breast cancer patients diagnosed during 1997-2013 at a single institute in Japan. The patients were followed until 2016. During a median follow-up period of 8.6 years, 272 all-cause and 199 breast cancer deaths were documented. RESULTS In case-case comparisons, later age at menarche was inversely associated with advanced tumors. Nulliparous patients tended to have receptor-positive [estrogen receptor (ER)+ or progesterone receptor (PR)+] tumors. Conversely, the Cox proportional-hazards model including adjustment for tumor characteristics revealed U-shaped relationship between parity number and the risk of all-cause death among the patients overall [hazard ratio (HR) = 2.10 for nulliparous, 1.28 for 2, and 1.50 for ≥ 3 vs. one child]. According to hormone receptor, later age at menarche and later age at last birth were positively associated with the risk of all-cause death among patients with ER- and PR- cancer (menarche, HR = 2.18 for ≥ 15 vs. ≤ 12 years, ptrend = 0.03; last birth, HR = 3.10 for ≥ 35 vs. ≤ 29 years, ptrend = 0.01). A shorter time since last birth was associated with the risk of death among receptor-positive patients (HR = 5.72 for ≤ 4 vs. ≥ 10 years, ptrend = 0.004). CONCLUSION The results indicate that the timing of menarche and parity have significant effects on patient survival, providing clues for understanding the association between women's life course and breast cancer outcome.
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Affiliation(s)
- Yuko Minami
- Division of Community Health, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. .,Division of Cancer Epidemiology and Prevention, Miyagi Cancer Center Research Institute, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, 981-1293, Japan. .,Center for Preventive Medicine, Osaki Citizen Hospital, 2-3-15 Senjuji-machi, Furukawa, Osaki, Miyagi, 989-6174, Japan.
| | - Yoshikazu Nishino
- Division of Cancer Epidemiology and Prevention, Miyagi Cancer Center Research Institute, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, 981-1293, Japan.,Department of Epidemiology and Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan
| | - Masaaki Kawai
- Department of Breast Surgery, Miyagi Cancer Center Hospital, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, 981-1239, Japan
| | - Hiroshi Tada
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Seiki Kanemura
- Division of Cancer Epidemiology and Prevention, Miyagi Cancer Center Research Institute, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, 981-1293, Japan
| | - Minoru Miyashita
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Takanori Ishida
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Yoichiro Kakugawa
- Department of Breast Surgery, Miyagi Cancer Center Hospital, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, 981-1239, Japan
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18
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Barclay K, Kolk M. Parity and Mortality: An Examination of Different Explanatory Mechanisms Using Data on Biological and Adoptive Parents. EUROPEAN JOURNAL OF POPULATION = REVUE EUROPEENNE DE DEMOGRAPHIE 2019; 35:63-85. [PMID: 30976268 PMCID: PMC6357259 DOI: 10.1007/s10680-018-9469-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/07/2018] [Indexed: 11/01/2022]
Abstract
A growing literature has demonstrated a relationship between parity and mortality, but the explanation for that relationship remains unclear. This study aims to pick apart physiological and social explanations for the parity-mortality relationship by examining the mortality of parents who adopt children, but who have no biological children, in comparison with the mortality of parents with biological children. Using Swedish register data, we study post-reproductive mortality amongst women and men from cohorts born between 1915 and 1960, over ages 45-97. Our results show the relative risks of mortality for adoptive parents are always lower than those of parents with biological children. Mortality amongst adoptive parents is lower for those who adopt more than one child, while for parents with biological children we observe a U-shaped relationship, where parity-two parents have the lowest mortality. Our discussion considers the relative importance of physiological and social depletion effects, and selection processes.
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Affiliation(s)
- Kieron Barclay
- Max Planck Institute for Demographic Research, 18057 Rostock, Germany
- Department of Social Policy, London School of Economics and Political Science, London, WC2A 2AE UK
- Department of Sociology, Stockholm University, 106 91 Stockholm, Sweden
| | - Martin Kolk
- Department of Sociology, Stockholm University, 106 91 Stockholm, Sweden
- Centre for the Study of Cultural Evolution, Stockholm University, 106 91 Stockholm, Sweden
- Institute for Futures Studies, Holländargatan 13, 101 31 Stockholm, Sweden
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19
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Fertility History and Physical and Mental Health Changes in European Older Adults. EUROPEAN JOURNAL OF POPULATION-REVUE EUROPEENNE DE DEMOGRAPHIE 2018; 35:459-485. [PMID: 31372101 PMCID: PMC6639520 DOI: 10.1007/s10680-018-9489-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 04/04/2018] [Indexed: 02/07/2023]
Abstract
Previous studies have shown that aspects of reproductive history, such as earlier parenthood and high parity, are associated with poorer health in mid and later life. However, it is unclear which dimensions of health are most affected by reproductive history, and whether the pattern of associations varies for measures of physical, psychological and cognitive health. Such variation might provide more insight into possible underlying mechanisms. We use longitudinal data for men and women aged 50–79 years in ten European countries from the Survey of Health, Ageing and Retirement in Europe to analyse associations between completed fertility history and self-reported and observed health indicators measured 2–3 years apart (functional limitations, chronic diseases, grip strength, depression and cognition), adjusting for socio-demographic, and health factors at baseline. Using multiple imputation and pattern mixture modelling, we tested the robustness of estimates to missing data mechanisms. The results are partly consistent with previous studies and show that women who became mothers before age 20 had worse functional health at baseline and were more likely to suffer functional health declines. Parents of 4 or more children had worse physical, psychological and cognitive health at baseline and were more likely to develop circulatory disease over the follow-up period. Men who delayed fatherhood until age 35 or later had better health at baseline but did not experience significantly different health declines. This study improves our understanding of linkages between fertility histories and later life health and possible implications of changes in fertility patterns for population health. However, research ideally using prospective life course data is needed to further elucidate possible mechanisms, considering interactions with partnership histories, health behaviour patterns and socio-economic trajectories.
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20
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Tavares AI. Women’s long-term health and age at parity. J Public Health (Oxf) 2017. [DOI: 10.1007/s10389-017-0874-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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21
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Li X, Jiang Q, Li S, Feldman MW. Female fertility history and mid-late-life health: Findings from China. J Women Aging 2017; 30:62-74. [PMID: 28151095 DOI: 10.1080/08952841.2016.1259445] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
China's middle-aged and older women suffer from poorer health than men. Using national baseline data from the China Health and Retirement Longitudinal Study (CHARLS), a survey conducted from 2011 to 2012, this article applies logistic models to investigate the association between female fertility history (parity, early childbearing, late childbearing) and middle-aged and late-life health. We find that parity is related to the mid-late-life health of women. Women with four children or more are more likely to suffer from activities of daily living (ADL) impairment and poorer self-rated health than those with one to three children. Early childbearing is associated with ADL impairment; however, the correlation is mediated by socioeconomic status. Early childbearing is related to self-rated health in later life by an indirect-only mediation effect via educational attainment and personal income.
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Affiliation(s)
- Xiaomin Li
- a Institute for Population and Development Studies , Xi'an Jiaotong University (China) , Xi'an City , Shaanxi Province, China
| | - Quanbao Jiang
- a Institute for Population and Development Studies , Xi'an Jiaotong University (China) , Xi'an City , Shaanxi Province, China
| | - Shuzhuo Li
- a Institute for Population and Development Studies , Xi'an Jiaotong University (China) , Xi'an City , Shaanxi Province, China
| | - Marcus W Feldman
- b Morrison Institute for Population and Resource Studies , Stanford University , Stanford , California , USA
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22
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Peters SAE, Yang L, Guo Y, Chen Y, Bian Z, Millwood IY, Wang S, Yang L, Hu Y, Liu J, Wang T, Chen J, Peto R, Li L, Woodward M, Chen Z. Parenthood and the risk of cardiovascular diseases among 0.5 million men and women: findings from the China Kadoorie Biobank. Int J Epidemiol 2017; 46:180-189. [PMID: 27649806 PMCID: PMC5837253 DOI: 10.1093/ije/dyw144] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 11/14/2022] Open
Abstract
Background Women's parity has been associated with risk of cardiovascular disease (CVD). It is unclear, however, whether it reflects biological effects of childbearing or uncontrolled socio-economic and lifestyle factors associated with childrearing. We assessed the association between number of children and incident CVD outcomes separately in women and men. Methods In 2004-08, the nationwide China Kadoorie Biobank recruited 0.5 million individuals aged 30-79 years from 10 diverse regions. During 7 years of follow-up, 24 432 incident cases of coronary heart disease (CHD) and 35 736 of stroke were recorded among 489 762 individuals without prior CVD. Multivariable Cox regression models were used to estimate sex-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for CHD and stroke associated with number of children. Results Overall, 98% of all participants had children and the mean number of children declined progressively from four in older participants to one or two in younger participants. Compared with childless women, women with children had an increased risk of CHD, but not of stroke [HR (95% CI): 1.14 (1.00; 1.30) and 1.03 (0.92; 1.16)]. Corresponding results for men were 1.20 (1.06; 1.35) and 1.13 (1.03; 1.24), respectively. In individuals with children, there was a log-linear association between number of children and CVD outcomes; in women, each additional child was associated with adjusted HRs of 1.02 (1.01; 1.04) for CHD and 1.02 (1.01; 1.03) for stroke, similar in magnitude to that in men [1.03 (1.01; 1.04) for CHD and 1.02 (1.01; 1.03) for stroke]. Conclusion In Chinese adults, the association between the number of children and risk of CHD and stroke was similar between men and women, suggesting that factors associated with parenthood and childrearing are more likely to affect the risk of CVD outcomes than factors associated with childbearing.
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Affiliation(s)
- Sanne AE Peters
- The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Ling Yang
- Clinical Trials Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK
| | - Yu Guo
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - Yiping Chen
- Clinical Trials Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - Iona Y Millwood
- Clinical Trials Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK
| | - Shaojie Wang
- Qingdao CDC NCDs Prevention and Control Department, Qingdao, Shandong, China
| | - Liqiu Yang
- Nangang CDC, Haerbin, Heilongjiang, China
| | - Yihe Hu
- Suzhou CDC NCDs Prevention and Control Department, Suzhou, Jiangsu, China
| | | | - Tao Wang
- Maiji CDC, Tianshui, Gansu, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Chaoyang District, Beijing, China
| | - Richard Peto
- Clinical Trials Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK
| | - Liming Li
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
- Department of Public Health, Beijing University, Beijing, China
| | - Mark Woodward
- The George Institute for Global Health, University of Oxford, Oxford, UK
- The George Institute for Global Health, University of Sydney, Australia and
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Zhengming Chen
- Clinical Trials Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK
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23
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Peters SAE, Yang L, Guo Y, Chen Y, Bian Z, Millwood IY, Bragg F, Zhou X, Ge P, Chen B, Gao Y, Li Y, Chen J, Li L, Woodward M, Chen Z. Parenthood and the risk of diabetes in men and women: a 7 year prospective study of 0.5 million individuals. Diabetologia 2016; 59:1675-82. [PMID: 27193915 PMCID: PMC4930461 DOI: 10.1007/s00125-016-3980-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 04/18/2016] [Indexed: 12/19/2022]
Abstract
AIMS/HYPOTHESIS In women, higher parity has been associated with increased risk of diabetes later in life. It is unclear, however, whether this association is mainly due to biological effects of childbearing, or to socioeconomic and lifestyle factors associated with childrearing. We assessed the association between number of children and diabetes risk separately in women and men. METHODS Between 2004 and 2008, the nationwide China Kadoorie Biobank recruited 0.5 million individuals aged 30-79 (mean 51 years) from ten diverse regions across China. During 7 years of follow-up, 8,840 incident cases of diabetes were recorded among 463,347 participants without prior cardiovascular diseases or diabetes. Multivariable Cox regression yielded sex-specific HRs and 95% CIs for incident diabetes by number of children. RESULTS Overall, ∼98% of all participants had children. In women, there was a J-shaped association between number of children and risk of diabetes. Compared with women with one child, the adjusted HRs for diabetes were 1.39 (95% CI 1.11, 1.73) for childless women, 1.12 (95% CI 1.07, 1.18) for those with two children, 1.23 (95% CI 1.16, 1.31) for those with three children, and 1.32 (95% CI 1.21, 1.44) for those with four or more children. In men, there was a similar association with risk of diabetes; the corresponding HRs were 1.28 (95% CI 1.02, 1.60), 1.19 (95% CI 1.12, 1.26), 1.32 (95% CI 1.21, 1.44) and 1.41 (95% CI 1.24, 1.60), respectively. In both sexes, the findings were broadly similar in different population subgroups. CONCLUSIONS/INTERPRETATION The similarity between women and men in the association between number of children and risk of diabetes suggests that parenthood is most likely to affect diabetes risk through factors associated with childrearing rather than via biological effects of childbearing.
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Affiliation(s)
- Sanne A E Peters
- The George Institute for Global Health, University of Oxford, 34 Broad Street, Oxford, OX1 3BD, UK
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Yu Guo
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, People's Republic of China
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, People's Republic of China
| | - Iona Y Millwood
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Fiona Bragg
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Xue Zhou
- Department of Prevention and Control of Non-Communicable Diseases, Heilongjiang Center for Disease Control and Prevention, Harbin, Heilongjiang, People's Republic of China
| | - Pengfei Ge
- Gansu Center for Disease Control and Prevention, Lanzhou, Gansu, People's Republic of China
| | - Biyun Chen
- Department of Prevention and Control of Non-Communicable Diseases, Hunan Center for Disease Control and Prevention, Hunan, Changsha, People's Republic of China
| | - Yulian Gao
- Huixian Center for Disease Control and Prevention, Huixian, Henan, People's Republic of China
| | - Yijun Li
- Department of Prevention and Control of Non-Communicable Diseases, Meilan Center for Disease Control and Prevention, Haikou, Hainan, People's Republic of China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Chaoyang District, Beijing, People's Republic of China
| | - Liming Li
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, People's Republic of China
- Department of Public Health, Beijing University, Beijing, People's Republic of China
| | - Mark Woodward
- The George Institute for Global Health, University of Oxford, 34 Broad Street, Oxford, OX1 3BD, UK.
- The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia.
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK.
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Einiö E, Nisén J, Martikainen P. Number of children and later-life mortality among Finns born 1938-50. Population Studies 2016; 70:217-38. [PMID: 27362776 DOI: 10.1080/00324728.2016.1195506] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We investigated the association between number of offspring and later-life mortality of Finnish men and women born 1938-50, and whether the association was explained by living conditions in own childhood and adulthood, chronic conditions, fertility timing, and unobserved characteristics common to siblings. We used a longitudinal 1950 census sample to estimate mortality at ages 50-72. Relative to parents of two children, all-cause mortality is highest among childless men and women, and elevated among those with one child, independently of observed confounders. Fixed-effect models, which control for unobserved characteristics shared by siblings, clearly support these findings among men. Cardiovascular mortality is higher among men with no, one, or at least four children than among those with two. Living conditions in adulthood contribute to the association between the number of children and mortality to a greater extent than childhood background, and chronic conditions contribute to the excess mortality of the childless.
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Affiliation(s)
| | | | - Pekka Martikainen
- a University of Helsinki.,b University of Stockholm / Karolinska Institute.,c Max Planck Institute for Demographic Research
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O’Flaherty M, Baxter J, Haynes M, Turrell G. The Family Life Course and Health: Partnership, Fertility Histories, and Later-Life Physical Health Trajectories in Australia. Demography 2016; 53:777-804. [DOI: 10.1007/s13524-016-0478-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Barclay K, Keenan K, Grundy E, Kolk M, Myrskylä M. Reproductive history and post-reproductive mortality: A sibling comparison analysis using Swedish register data. Soc Sci Med 2016; 155:82-92. [DOI: 10.1016/j.socscimed.2016.02.043] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/12/2016] [Accepted: 02/28/2016] [Indexed: 01/29/2023]
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Hayward AD, Nenko I, Lummaa V. Early-life reproduction is associated with increased mortality risk but enhanced lifetime fitness in pre-industrial humans. Proc Biol Sci 2015; 282:20143053. [PMID: 25740893 DOI: 10.1098/rspb.2014.3053] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The physiology of reproductive senescence in women is well understood, but the drivers of variation in senescence rates are less so. Evolutionary theory predicts that early-life investment in reproduction should be favoured by selection at the cost of reduced survival and faster reproductive senescence. We tested this hypothesis using data collected from preindustrial Finnish church records. Reproductive success increased up to age 25 and was relatively stable until a decline from age 41. Women with higher early-life fecundity (ELF; producing more children before age 25) subsequently had higher mortality risk, but high ELF was not associated with accelerated senescence in annual breeding success. However, women with higher ELF experienced faster senescence in offspring survival. Despite these apparent costs, ELF was under positive selection: individuals with higher ELF had higher lifetime reproductive success. These results are consistent with previous observations in both humans and wild vertebrates that more births and earlier onset of reproduction are associated with reduced survival, and with evolutionary theory predicting trade-offs between early reproduction and later-life survival. The results are particularly significant given recent increases in maternal ages in many societies and the potential consequences for offspring health and fitness.
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Affiliation(s)
- Adam D Hayward
- Department of Animal and Plant Sciences, University of Sheffield, Sheffield, UK Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, UK
| | - Ilona Nenko
- Department of Animal and Plant Sciences, University of Sheffield, Sheffield, UK Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University, Krakow, Poland
| | - Virpi Lummaa
- Department of Animal and Plant Sciences, University of Sheffield, Sheffield, UK
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Natural fertility and longevity. Fertil Steril 2015; 103:1109-16. [PMID: 25934597 DOI: 10.1016/j.fertnstert.2015.03.030] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 03/23/2015] [Accepted: 03/25/2015] [Indexed: 12/25/2022]
Abstract
Much empirical work suggests an association between fertility patterns and longevity. I review this association, focusing on natural fertility populations and emphasizing the role of both the timing and the intensity of fertility. Overall, it appears that although age at last reproduction routinely correlates with post-reproductive longevity, suggesting a slower rate of senescence among late fertile women, the same is not true for age at first reproduction and parity. I discuss some of the conceptual and methodologic issues, as well as the sources of the biases, that have been a persistent feature of this body of research. I conclude by suggesting avenues of research that could be initiated or pursued in the area.
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Christiansen SG. The impact of children's sex composition on parents' mortality. BMC Public Health 2014; 14:989. [PMID: 25246080 PMCID: PMC4179844 DOI: 10.1186/1471-2458-14-989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 09/15/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study explores the relationship between children's sex composition and parents' mortality in a contemporary western society. It improves on earlier research by using a larger and more representative dataset - constructed from registers and encompassing the entire Norwegian population. METHODS The analysis is based on discrete-time hazard models, estimated for the years 1980-2008 for women and men born after 1935. RESULTS When operationalising sex composition as the "number of boys", coefficients are insignificant in all specifications. However, when considering the three categories "only boys", "only girls" and "mixed sex", I find a small but significant disadvantage of having only girls, compared to having at least one child of each sex, for mothers of two or more children. Having only daughters is associated with a mortality disadvantage compared to having only sons for mothers of two children, but a mortality advantage among mothers with four children. Among women who gave birth to their first child as teenagers, those who have only sons have relatively high mortality. I also find an excess mortality both for mothers of only girls and mothers of only boys in the period 1980-1989. CONCLUSION These results lend some support to the notion that there is a larger benefit of the first son or daughter than the later children of the same sex, and especially in the earliest decade of the study period.
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Christiansen SG. The association between grandparenthood and mortality. Soc Sci Med 2014; 118:89-96. [PMID: 25108695 DOI: 10.1016/j.socscimed.2014.07.061] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 06/28/2014] [Accepted: 07/28/2014] [Indexed: 10/25/2022]
Abstract
Few studies have so far enquired into the relationship between being a grandparent and health and mortality outcomes, and the majority of these have looked exclusively at grandparents who take over parenting responsibility for their grandchildren. This study aims to fill this gap in the knowledge of how family structure is linked to mortality by focusing on whether being a grandparent in itself is associated with mortality. Norwegian parents in the age groups 40-73 are analysed using register data that encompass the entire population. The analysis is based on discrete-time hazard models, estimated for the years 1980-2008. I find a mortality disadvantage of being a grandfather, which is particularly strong for those who become grandfathers at an early age. Controlling for characteristics of the middle generation such as sex, education and marital status does not remove the association. For men the mortality disadvantage is not influenced by the number of grandchildren or the number of sets of grandchildren. For women there is significantly higher mortality only for those who become grandmothers in their thirties or forties, who are married or who have many children. Becoming a grandmother after age 50 is associated with significantly lower mortality. At least part of these associations are likely due to selection effects, however they may also to some extent be caused by the individuals' relationship with grandchildren, and children who have become parents themselves.
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Grundy E, Kravdal Ø. Do short birth intervals have long-term implications for parental health? Results from analyses of complete cohort Norwegian register data. J Epidemiol Community Health 2014; 68:958-64. [PMID: 25009153 PMCID: PMC4174138 DOI: 10.1136/jech-2014-204191] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Short and very long interbirth intervals are associated with worse perinatal, infant and immediate maternal outcomes. Accumulated physiological, mental, social and economic stresses arising from raising children close in age may also mean that interbirth intervals have longer term implications for the health of mothers and fathers, but few previous studies have investigated this. METHODS Discrete-time hazards models were estimated to analyse associations between interbirth intervals and mortality risks for the period 1980-2008 in complete cohorts of Norwegian men and women born during 1935-1968 who had had two to four children. Associations between interbirth intervals and use of medication during 2004-2008 were also analysed using ordinary least-squares regression. Covariates included age, year, education, age at first birth, parity and change in coparent since the previous birth. RESULTS Mothers and fathers of two to three children with intervals between singleton births of less than 18 months, and mothers of twins, had raised mortality risks in midlife and early old age relative to parents with interbirth intervals of 30-41 months. For parents with three or four children, longer average interbirth intervals were associated with lower mortality. Short intervals between first and second births were also positively associated with medication use. Very long intervals were not associated with raised mortality or medication use when change of coparent since the previous birth was controlled. CONCLUSIONS Closely spaced and multiple births may have adverse long-term implications for parental health. Delayed entry to parenthood and increased use of fertility treatments mean that both are increasing, making this a public health issue which needs further investigation.
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Affiliation(s)
- Emily Grundy
- Department of Social Policy, London School of Economics, London, UK
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32
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The mid-twentieth century Baby Boom and the changing educational gradient in Belgian cohort fertility. DEMOGRAPHIC RESEARCH 2014. [DOI: 10.4054/demres.2014.30.33] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Kengeri SS, Maras AH, Suckow CL, Chiang EC, Waters DJ. Exceptional longevity in female Rottweiler dogs is not encumbered by investment in reproduction. AGE (DORDRECHT, NETHERLANDS) 2013; 35:2503-2513. [PMID: 23584889 PMCID: PMC3825016 DOI: 10.1007/s11357-013-9529-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 03/18/2013] [Indexed: 06/02/2023]
Abstract
To better understand the potential trade-off between female reproductive investment and longevity in an emerging model of human healthspan, we studied pet dogs to determine whether intensity of reproduction (total number of offspring) encumbered the likelihood of exceptional longevity. This hypothesis was tested by collecting and analyzing lifetime medical histories, including complete reproductive histories, for a cohort of canine "centenarians"--exceptionally long-lived Rottweiler dogs that lived more than 30% longer than the breed's average life expectancy. Reproductive intensity (number of litters, total number of pups) and tempo of reproductive effort (age at first reproduction, mean interbirth interval, age at last reproduction) in 78 exceptionally long-lived female Rottweilers (>13 years old) were compared to a cohort of 97 female Rottweilers that had usual longevity (age at death 8.0-10.75 years). We found no evidence that a mother's physiological investment in offspring was associated with disadvantaged longevity. Instead, similar to some studies in women, our data showed an inverted U-shaped trend, suggesting that moderate investment in reproduction may promote longevity. Late reproductive success, a much-studied surrogate of maternal fitness in women, was not a strong predictor of longevity in this canine cohort. Instead, independent of reproductive investment, the duration of lifetime ovary exposure was significantly associated with highly successful aging. Our results from exceptionally long-lived pet dogs provide rationale for further investigative efforts to understand the ovary-sensitive biological factors that promote healthy longevity in women and pet dogs.
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Affiliation(s)
- S. S. Kengeri
- />Center for Exceptional Longevity Studies, Gerald P. Murphy Cancer Foundation, West Lafayette, IN USA
| | - A. H. Maras
- />Center for Exceptional Longevity Studies, Gerald P. Murphy Cancer Foundation, West Lafayette, IN USA
| | - C. L. Suckow
- />Center for Exceptional Longevity Studies, Gerald P. Murphy Cancer Foundation, West Lafayette, IN USA
| | - E. C. Chiang
- />Center for Exceptional Longevity Studies, Gerald P. Murphy Cancer Foundation, West Lafayette, IN USA
- />Center on Aging and the Life Course, Purdue University, West Lafayette, IN USA
| | - D. J. Waters
- />Center for Exceptional Longevity Studies, Gerald P. Murphy Cancer Foundation, West Lafayette, IN USA
- />Center on Aging and the Life Course, Purdue University, West Lafayette, IN USA
- />Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN USA
- />Center for Exceptional Longevity Studies, Gerald P. Murphy Cancer Foundation, 3000 Kent Avenue, Suite E2-100, West Lafayette, IN 47906 USA
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Dior UP, Hochner H, Friedlander Y, Calderon-Margalit R, Jaffe D, Burger A, Avgil M, Manor O, Elchalal U. Association between number of children and mortality of mothers: results of a 37-year follow-up study. Ann Epidemiol 2012. [PMID: 23176782 DOI: 10.1016/j.annepidem.2012.10.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To examine the association between parity and long-term, all-cause mortality and mortality owing to specific causes in women. METHODS This prospective population-based study included 40,454 mothers who gave birth in Western Jerusalem, Israel, to 125,842 children and were followed for an average of 37 years after the birth of their first child. Cox proportional hazards models were used to evaluate long-term total and specific-cause mortality of women by their parity. RESULTS We found a U-shaped relationship between the number of offspring and risk of all-cause mortality in mothers. After adjustment for sociodemographic characteristics and maternal health and obstetric conditions, higher mortality rates were observed for mothers of 1 child (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.04-1.4), mothers of 5 to 9 children (HR, 1.21; 95% CI, 1.09-1.33), and mothers of 10 or more children (HR, 1.49; 95% CI, 1.12-1.99) compared with mothers of 2 to 4 children. Mortality risk from specific causes including coronary disease, circulatory disease, and cancer were increased for multiparous women. CONCLUSIONS In this long-term follow-up study, there was an association between number of children and mortality risk for mothers. These findings suggest that maternal pregnancies and postnatal characteristics as reflected by number of children may have consequences for long-term maternal health.
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Affiliation(s)
- Uri P Dior
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel.
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Simons LA, Simons J, Friedlander Y, McCallum J. Childbearing history and late-life mortality: the Dubbo study of Australian elderly. Age Ageing 2012; 41:523-8. [PMID: 22459707 DOI: 10.1093/ageing/afs016] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE to examine the association of parity with mortality in later life. DESIGN a longitudinal, community-based study. SETTING semi-rural town of Dubbo, NSW, Australia. SUBJECTS a total of 1,571 women and 1,233 men 60 years and older first examined in 1988-89. OUTCOME MEASURES all-cause and cause-specific mortality rates analysed over 16-year follow-up. Hazard ratios obtained from proportional hazards models employing conventional predictors, potential confounders and measure of parity. RESULTS increasing parity in women was weakly associated with overweight, diabetes and hypertension. All-cause mortality fell progressively with increasing parity in women (hazard ratio and 95% confidence intervals): childless, 1.00; 1 child, 1.03 (0.75-1.43); 2 children, 0.83 (0.61-1.11); 3 children, 0.80 (0.60-1.08); 4 children, 0.91 (0.66-1.25); 5 children, 0.70 (0.49-1.01); 6+ children, 0.60 (0.43-0.85) (trend for parity P<0.002). This result was similar whether or not hypertension, diabetes and overweight were included in multivariate models adjusting for social variables and other confounders. The reduction in all-cause mortality was accompanied by a parallel reduction in deaths from cancer and respiratory conditions, while coronary heart disease mortality increased 60-111% in all parous women. CONCLUSION there was increased all-cause mortality in later life in childless women, accompanied by reduced mortality as parity increased. Underlying mechanisms are unclear but findings may have public health importance.
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Affiliation(s)
- Leon A Simons
- Lipid Department, St Vincent's Hospital, University of NSW, Sydney, New South Wales, Australia.
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Widowhood, illegitimacy, marital reproduction and female longevity in a rural Spanish population. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2011; 62:500-9. [PMID: 21975362 DOI: 10.1016/j.jchb.2011.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 06/18/2011] [Indexed: 11/23/2022]
Abstract
Using data from parish and civil registers in a rural community in northwest Spain (Los Nogales), family reconstitution provided 1502 complete reproductive histories, of which 584 corresponded to first marriages of women dying after their 50th birthday. A homogeneous sample consisting of women married in the period 1877-1899 (N=311) provided information concerning their reproductive performance, including ages at first and last maternity and number of children born alive and surviving, which was related to the mother's post-menopausal longevity, also considering premarital fertility and her marital status (widow/married). The results obtained indicate that mothers with a lower proportion of children dying before the first birthday and the age of 15 (mainly males) have a greater post-reproductive longevity. Moreover, women with a more protracted end to their reproductive period and greater fertility live for more years beyond their 50th birthday. These results do not prove a causality between maternal longevity and more successful reproduction; instead, they are indicative of a holistic condition of health. A wide spectrum of favorable biological and environmental factors will have positive consequences for a woman's life trajectory, affecting both her reproductive performance and her own likelihood of surviving.
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Jacobsen BK, Knutsen SF, Oda K, Fraser GE. Parity and total, ischemic heart disease and stroke mortality. The Adventist Health Study, 1976-1988. Eur J Epidemiol 2011; 26:711-8. [PMID: 21701914 PMCID: PMC3186890 DOI: 10.1007/s10654-011-9598-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 06/11/2011] [Indexed: 11/30/2022]
Abstract
In a prospective study with information about life style and reproductive factors, we assessed the relationship between parity and total, ischemic heart disease, and stroke mortality. The large majority of the 19,688 California Seventh-day Adventist women included did not smoke or drink alcohol, 31 percent never ate meat and physical activity was relatively high. Cox proportional hazard analysis was conducted with parity as the main independent variable and with adjustment for a number of other possible confounders. During follow-up from 1976 through 1988, there were 3,122 deaths; 782 deaths from ischemic heart disease and 367 deaths due to stroke. There were no relationships between parity and total mortality (P-value for overall effect of parity = 0.32). Grand multiparous women (>4 children) had somewhat increased ischemic heart disease mortality (MRR = 1.45, 95% CI: 1.15, 1.84) before adjustment for educational level. After adjustment for educational level and marital status, there were no relationship with mortality from ischemic heart disease (P = 0.29) or stroke (P = 0.72). In parous women, there were, after adjustment for age at first delivery, some suggestions of an increased total mortality in women with one child. For ischemic heart disease and stroke mortality, no associations were found. Stratified and adjusted analyses confirmed these results. Thus, we found no consistent relationships between parity and total, ischemic heart disease or stroke mortality. However, a longer follow-up would have been helpful and the conclusions may be somewhat influenced by the lifestyle of the women included.
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Hank K. Childbearing history, later-life health, and mortality in Germany. Population Studies 2010; 64:275-91. [DOI: 10.1080/00324728.2010.506243] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
ABSTRACTIn this paper we examine associations between the fertility histories of older British women and men and their quality of life using data on a sample of 6,374 men and women born between 1923 and 1949 drawn from the British Household Panel Survey (BHPS). Quality of life in 2001 was measured using scores from the four subscales of the CASP-19 questionnaire: control, autonomy, pleasure and self-realisation. Fertility histories were derived using information on the births of children collected in all waves of the BHPS. The aspects of fertility history investigated were number of children born and parents' ages at birth of first and last child. Age, education, marital status, tenure status, smoking, co-residence with one or more children, perceived social support and health limitations were included as covariates. The results suggested that early entry to parenthood and to some extent high parity were related to poorer quality of life. These associations were mostly mediated by socio-economic, social support and health factors. Compared to women with two children, nulliparous women expressed a higher level of autonomy, and both nulliparous women and those with four or more children a higher level of self-realisation. Low parity was related to a lower level of pleasure, especially among men, but this relationship appeared weaker and among women was not significant when background factors were controlled.
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Sear R, Gibson M. Introduction to special issue on "Trade-Offs in Female Life Histories: Integrating Evolutionary Frameworks". Am J Hum Biol 2009; 21:417-20. [PMID: 19418528 DOI: 10.1002/ajhb.20952] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Rebecca Sear
- Department of Social Policy, London School of Economics, United Kingdom
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