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Pszczołowska M, Walczak K, Miśków W, Mroziak M, Kozłowski G, Beszłej JA, Leszek J. Association between Female Reproductive Factors and Risk of Dementia. J Clin Med 2024; 13:2983. [PMID: 38792524 PMCID: PMC11122498 DOI: 10.3390/jcm13102983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/07/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Women have an over 50% greater risk of dementia than men, which is a main topic of much research. This review aims to investigate the impact of a woman's reproductive history on dementia risk. The consequences of stillbirth are long-term health and psychosocial problems for women. Because of the awareness of an endangered pregnancy, many parents experience deep anxiety and stress in subsequent pregnancies. There are contradictory conclusions from research about abortion and the risk of dementia correlation. When it comes to the late age of first birth, which is said to be above 35 years old, it was observed that older mothers have a decreased risk of dementia compared to those who gave birth in their 20s; however, being a child of the older mother is connected with a higher risk of developing dementia. Using hormonal contraception can result in decreased risk of dementia as estrogen stimulates microglia-related Aβ removal and reduces tau hyperphosphorylation. The influence of postmenopausal hormonal therapy and the duration of the reproductive period on developing dementia remains unclear. Although female disorders like endometriosis and polycystic ovary syndrome are reported to increase the risk of dementia, the research on this topic is very limited, especially when it comes to endometriosis, and needs further investigation. Interestingly, there is no conclusion on whether hypertensive disorders of pregnancy increase the risk of dementia, but most articles seem to confirm this theory.
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Affiliation(s)
| | - Kamil Walczak
- Faculty of Medicine, Wrocław Medical University, 50-367 Wrocław, Poland
| | - Weronika Miśków
- Faculty of Medicine, Wrocław Medical University, 50-367 Wrocław, Poland
| | - Magdalena Mroziak
- Faculty of Medicine, Wrocław Medical University, 50-367 Wrocław, Poland
| | - Gracjan Kozłowski
- Faculty of Medicine, Wrocław Medical University, 50-367 Wrocław, Poland
| | - Jan Aleksander Beszłej
- Clinic of Psychiatry, Department of Psychiatry, Medical Department, Wrocław Medical University, 50-367 Wrocław, Poland
| | - Jerzy Leszek
- Clinic of Psychiatry, Department of Psychiatry, Medical Department, Wrocław Medical University, 50-367 Wrocław, Poland
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de Kat AC, Roelofs F, Slagboom PE, Broekmans FJM, Beekman M, Berg NVD. Late reproduction is associated with extended female survival but not with familial longevity. Reprod Biomed Online 2024; 49:104073. [PMID: 38964280 DOI: 10.1016/j.rbmo.2024.104073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 04/03/2024] [Accepted: 04/09/2024] [Indexed: 07/06/2024]
Abstract
RESEARCH QUESTION Are age at last childbirth and number of children, as facets of female reproductive health, related to individual lifespan or familial longevity? DESIGN This observational study included 10,255 female participants from a multigenerational historical cohort, the LINKing System for historical family reconstruction (LINKS), and 1258 female participants from 651 long-lived families in the Leiden Longevity Study (LLS). Age at last childbirth and number of children, as outcomes of reproductive success, were compared with individual and familial longevity using the LINKS dataset. In addition, the genetic predisposition in the form of a polygenic risk score (PRS) for age at menopause was studied in relation to familial longevity using the LLS dataset. RESULTS For each year increase in the age of the birth of the last child, a woman's lifespan increased by 0.06 years (22 days; P = 0.002). The yearly risk for having a last child was 9% lower in women who survived to the oldest 10% of their birth cohort (hazard ratio 0.91, 95% CI 0.86-0.95). Women who came from long-living families did not have a higher mean age of last childbirth. There was no significant association between familial longevity and genetic predisposition to age at menopause. CONCLUSIONS Female reproductive health associates with a longer lifespan. Familial longevity does not associate to extended reproductive health. Other factors in somatic maintenance that support a longer lifespan are likely to have an impact on reproductive health.
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Affiliation(s)
- Annelien C de Kat
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands..
| | - Femke Roelofs
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P Eline Slagboom
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Frank J M Broekmans
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marian Beekman
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Niels van den Berg
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
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3
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Lenzi C, Piat A, Schlich P, Ducau J, Bregliano JC, Aguilaniu H, Laurençon A. Parental age effect on the longevity and healthspan in Drosophila melanogaster and Caenorhabditis elegans. Aging (Albany NY) 2023; 15:11720-11739. [PMID: 37917003 PMCID: PMC10683632 DOI: 10.18632/aging.205098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 09/18/2023] [Indexed: 11/03/2023]
Abstract
Several studies have investigated the effect of parental age on biological parameters such as reproduction, lifespan, and health; however, the results have been inconclusive, largely due to inter-species variation and/or modest effect sizes. Here, we examined the effect of parental age on the lifespan, reproductive capacity, and locomotor activity of genetic isogenic lines of the nematode Caenorhabditis elegans and the fruit fly Drosophila melanogaster. We found that the progeny of successive generations of old parents had significantly shorter lifespans than the progeny of young parents in both species. Moreover, we investigated the fertility, fecundity, and locomotor activity of C. elegans. Interestingly, both the shorter lifespan and deteriorated healthspan of the progeny were significantly improved by switching to only one generation of younger parents. Collectively, these data demonstrate that the detrimental effect of older parental age on the longevity of the progeny can be reversed, suggesting the existence of a beneficial non-genetic mechanism.
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Affiliation(s)
| | | | - Pascal Schlich
- INRA, Centre des Sciences du Goût et de l’Alimentation (CSGA), Dijon, France
| | - Judith Ducau
- IBDM, Parc Scientifique de Luminy, Marseille, France
| | | | | | - Anne Laurençon
- Institut de Genomique Fonctionnelle de Lyon, UMR5242, Universite Claude Bernard-Lyon 1, Ecole Normale Superieure de Lyon, Lyon, France
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Athar F, Templeman NM. C. elegans as a model organism to study female reproductive health. Comp Biochem Physiol A Mol Integr Physiol 2022; 266:111152. [PMID: 35032657 DOI: 10.1016/j.cbpa.2022.111152] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 12/17/2022]
Abstract
Female reproductive health has been historically understudied and underfunded. Here, we present the advantages of using a free-living nematode, Caenorhabditis elegans, as an animal system to study fundamental aspects of female reproductive health. C. elegans is a powerful high-throughput model organism that shares key genetic and physiological similarities with humans. In this review, we highlight areas of pressing medical and biological importance in the 21st century within the context of female reproductive health. These include the decline in female reproductive capacity with increasing chronological age, reproductive dysfunction arising from toxic environmental insults, and cancers of the reproductive system. C. elegans has been instrumental in uncovering mechanistic insights underlying these processes, and has been valuable for developing and testing therapeutics to combat them. Adopting a convenient model organism such as C. elegans for studying reproductive health will encourage further research into this field, and broaden opportunities for making advancements into evolutionarily conserved mechanisms that control reproductive function.
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Affiliation(s)
- Faria Athar
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Nicole M Templeman
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada.
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Michaeli J, Smoom R, Serruya N, El Ayoubi H, Rotshenker-Olshinka K, Srebnik N, Michaeli O, Eldar-Geva T, Tzfati Y. Leukocyte Telomere Length Correlates with Extended Female Fertility. Cells 2022; 11:cells11030513. [PMID: 35159322 PMCID: PMC8834216 DOI: 10.3390/cells11030513] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 12/04/2022] Open
Abstract
Current social trends of delayed reproduction to the fourth and fifth decade of life call for a better understanding of reproductive aging. Demographic studies correlated late reproduction with general health and longevity. Telomeres, the protective ends of eukaryotic chromosomes, were implicated in various aging-associated pathologies and longevity. To examine whether telomeres are also associated with reproductive aging, we measured by Southern analysis the terminal restriction fragments (TRF) in leukocytes of women delivering a healthy infant following a spontaneous pregnancy at 43–48 years of age. We compared them to age-matched previously fertile women who failed to conceive above age 41. The average TRF length in the extended fertility group (9350 bp) was significantly longer than in the normal fertility group (8850 bp; p-value = 0.03). Strikingly, excluding women with nine or more children increased the difference between the groups to over 1000 bp (9920 and 8880 bp; p-value = 0.0009). Nevertheless, we observed no apparent effects of pregnancy, delivery, or parity on telomere length. We propose that longer leukocyte telomere length reflects higher oocyte quality, which can compensate for other limiting physiological and behavioral factors and enable successful reproduction. Leukocyte telomere length should be further explored as a novel biomarker of oocyte quality for assessing reproductive potential and integrating family planning with demanding women’s careers.
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Affiliation(s)
- Jennia Michaeli
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center Affiliated with the Hebrew University School of Medicine, Jerusalem 9103102, Israel; (K.R.-O.); (N.S.); (T.E.-G.)
- Department of Genetics, The Silberman Institute of Life Sciences, The Hebrew University of Jerusalem, Givat Ram, Jerusalem 91904, Israel; (R.S.); (N.S.); (H.E.A.); (O.M.)
- Correspondence: (J.M.); (Y.T.)
| | - Riham Smoom
- Department of Genetics, The Silberman Institute of Life Sciences, The Hebrew University of Jerusalem, Givat Ram, Jerusalem 91904, Israel; (R.S.); (N.S.); (H.E.A.); (O.M.)
| | - Noa Serruya
- Department of Genetics, The Silberman Institute of Life Sciences, The Hebrew University of Jerusalem, Givat Ram, Jerusalem 91904, Israel; (R.S.); (N.S.); (H.E.A.); (O.M.)
| | - Hosniyah El Ayoubi
- Department of Genetics, The Silberman Institute of Life Sciences, The Hebrew University of Jerusalem, Givat Ram, Jerusalem 91904, Israel; (R.S.); (N.S.); (H.E.A.); (O.M.)
| | - Keren Rotshenker-Olshinka
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center Affiliated with the Hebrew University School of Medicine, Jerusalem 9103102, Israel; (K.R.-O.); (N.S.); (T.E.-G.)
| | - Naama Srebnik
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center Affiliated with the Hebrew University School of Medicine, Jerusalem 9103102, Israel; (K.R.-O.); (N.S.); (T.E.-G.)
| | - Ofir Michaeli
- Department of Genetics, The Silberman Institute of Life Sciences, The Hebrew University of Jerusalem, Givat Ram, Jerusalem 91904, Israel; (R.S.); (N.S.); (H.E.A.); (O.M.)
| | - Talia Eldar-Geva
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center Affiliated with the Hebrew University School of Medicine, Jerusalem 9103102, Israel; (K.R.-O.); (N.S.); (T.E.-G.)
| | - Yehuda Tzfati
- Department of Genetics, The Silberman Institute of Life Sciences, The Hebrew University of Jerusalem, Givat Ram, Jerusalem 91904, Israel; (R.S.); (N.S.); (H.E.A.); (O.M.)
- Correspondence: (J.M.); (Y.T.)
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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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Laven JSE. Genetics of Menopause and Primary Ovarian Insufficiency: Time for a Paradigm Shift? Semin Reprod Med 2021; 38:256-262. [PMID: 33648006 DOI: 10.1055/s-0040-1721796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This review summarizes the existing information concerning the genetic background of menopause and primary ovarian insufficiency (POI). There is overwhelming evidence that majority of genes are involved in double-strand break repair, mismatch repair, and base excision repair. The remaining loci were involved in cell energy metabolism and immune response. Gradual (or in case of rapid POI) accumulation of unrepaired DNA damage causes (premature) cell death and cellular senescence. This in turn leads to exhaustion of cell renewal capacity and cellular dysfunction in affected organs and eventually to aging of the entire soma. Similar erosion of the genome occurs within the germ cell line and the ovaries. Subsequently, the systemic "survival" response intentionally suppresses the sex-steroid hormonal output, which in turn may contribute to the onset of menopause. The latter occurs in particular when age-dependent DNA damage accumulation does not cease. Both effects are expected to synergize to promote (premature) ovarian silencing and install (early) menopause. Consequently, aging of the soma seems to be a primary driver for the loss of ovarian function in women. This challenges the current dogma which implies that loss of ovarian function initiates aging of the soma. It is time for a paradigm shift!
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Affiliation(s)
- Joop S E Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, The Netherlands
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8
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Correa-de-Araujo R, Yoon SS(S. Clinical Outcomes in High-Risk Pregnancies Due to Advanced Maternal Age. J Womens Health (Larchmt) 2021; 30:160-167. [PMID: 33185505 PMCID: PMC8020515 DOI: 10.1089/jwh.2020.8860] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Although the influence of advanced maternal age (AMA) and delayed childbearing on adverse maternal and perinatal outcomes has been studied extensively, no universal consensus on the definition of AMA exists. This terminology currently refers to the later years of a woman's reproductive life span and generally applies to women age ≥35 years. AMA increases the risk of pregnancy complications, including ectopic pregnancy, spontaneous abortion, fetal chromosomal abnormalities, congenital anomalies, placenta previa and abruption, gestational diabetes, preeclampsia, and cesarean delivery. Such complications could be the cause of preterm birth and increase the risk of perinatal mortality. For women who have a chronic illness, pregnancy may lead to additional risk that demands increased monitoring or surveillance. The management of pregnant women of AMA requires understanding the relationship between age and preexisting comorbidities. The outcomes from pregnancy in AMA may have a negative impact on women's health as they age because of both the changes from the pregnancy itself and the increased risk of pregnancy-related complications. Postpartum depression affects women of AMA at higher rates. Links between preeclampsia and the risk of future development of cardiovascular disease require follow-up surveillance. The association between hypertensive pregnancy disorders and cognitive and brain functions needs further investigation of sex-specific risk factors across the life span. Educating providers and women of AMA is crucial to facilitate clinical decision making and such education should consider cultural influences, risk perception, and women's health literacy, as well as providers' biases and system issues.
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Affiliation(s)
- Rosaly Correa-de-Araujo
- Division of Geriatrics and Clinical Gerontology, U.S. Department of Health and Human Services, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Sung Sug (Sarah) Yoon
- Division of Extramural Science Programs, U.S. Department of Health and Human Services, National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, USA
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O’Kelly AC, Scott NS. Cardiovascular Evaluation and Considerations for Women of Advanced Maternal Age Desiring Pregnancy. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2020. [DOI: 10.1007/s11936-020-00857-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Tzur Y, Yogev Y. Prepregnancy counseling in women over 50 years of age. Best Pract Res Clin Obstet Gynaecol 2020; 70:21-27. [PMID: 32773290 DOI: 10.1016/j.bpobgyn.2020.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/17/2020] [Accepted: 07/01/2020] [Indexed: 10/23/2022]
Abstract
Over the past decade, there has been a steep rise in the proportion of women who become pregnant at an advanced maternal age. Personal goals and cultural changes along with the advancement in artificial reproductive therapies have enabled women who wish to defer childbearing when given an opportunity to do so, and pregnancy rates in this age group are not likely to decrease. However, accumulating evidence suggests that pregnancies at an advanced maternal age are associated with an increased risk for maternal and neonatal complications. This review provides an evidence-based view of advanced maternal age pregnancy and focuses on prepregnancy counseling to optimize women's health prior to conception.
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Affiliation(s)
- Yossi Tzur
- Lis Maternity Hospital, Department of Obstetrics & Gynecology, Sourasky Medical Center, Tel Aviv University, Israel
| | - Yariv Yogev
- Lis Maternity Hospital, Department of Obstetrics & Gynecology, Sourasky Medical Center, Tel Aviv University, Israel.
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The impact of advanced maternal age on pregnancy outcome. Best Pract Res Clin Obstet Gynaecol 2020; 70:2-9. [PMID: 32773291 DOI: 10.1016/j.bpobgyn.2020.06.006] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/08/2020] [Indexed: 01/24/2023]
Abstract
Advanced maternal age is becoming an increasingly relevant issue in high-income developed countries. Lower fertility, greater need for assisted reproductive therapy, and an increase in comorbidities, such as hypertension and diabetes, are some of the reasons for the rise in adverse maternal and fetal outcomes. This chapter reviews and summarizes the recent publications on the impact of advanced maternal age on pregnancy outcomes.
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Rattay P, von der Lippe E. Association between Living with Children and the Health and Health Behavior of Women and Men. Are There Differences by Age? Results of the "German Health Update" (GEDA) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3180. [PMID: 32370290 PMCID: PMC7246668 DOI: 10.3390/ijerph17093180] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 01/01/2023]
Abstract
Does the health of women and men living with and without minor children differ, and are age differences evident in the association? For self-rated general health, depression, back pain, overweight, smoking and sporting inactivity, the GEDA data 2009-2012 (18-54 years, n = 39,096) were used to calculate prevalence for women and men stratified by parental status (living with children: yes/no) and age. Moreover, we calculated odds ratios and predictive margins, performing logistic regressions with interaction terms of parental status and age. Women and men aged 45-54 living with children are healthier than those not living with children. Parents aged 18-24 smoke more frequently and do less sport; young mothers are also more likely to be overweight and suffer from back pain than women not living with children. In multivariable analysis, the interaction of living with children and age is significant for all outcomes (except depression and back pain in men). Living with children is an important social determinant of health, highly dependent on age. It is to be discussed whether the bio-psycho-social situation has an influence on becoming a parent, or whether parenthood in different phases of life strains or enhances health.
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Affiliation(s)
- Petra Rattay
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany;
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Stentz NC, Koelper N, Barnhart KT, Sammel MD, Senapati S. Infertility and mortality. Am J Obstet Gynecol 2020; 222:251.e1-251.e10. [PMID: 31526792 DOI: 10.1016/j.ajog.2019.09.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/21/2019] [Accepted: 09/06/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Infertility affects 1 in 10 American reproductive-age women. The impact of this disease beyond the reproductive years is largely unknown. OBJECTIVE The objective of the study was to determine the association of infertility history with all-cause and cause-specific mortality. STUDY DESIGN This secondary analysis of a multicenter randomized clinical trial included 75,784 women (aged 55-74 years) prospectively enrolled in the Prostate, Lung, Colorectal, and Ovarian cancer-screening trial from 1992 through 2001 and followed up a minimum of 10 years for health-related outcomes and death (856,935 person-years). We examined the association of infertility history (inability to conceive for 1 year or greater) of all-cause and cause-specific mortality using disease risk score-adjusted Cox-proportional hazard regression models. RESULTS Infertile women had a 10% increased risk of death (from any cause) during the study period compared with the unexposed (adjusted hazard risk, 1.10, 95% confidence interval, 1.02-1.18, P = .010). This effect was predominantly noted in women at an otherwise low risk of mortality who had a 26% increased risk of death (adjusted hazard risk, 1.26, 95% confidence interval, 1.12-1.42, P < .001). No differences in cardiovascular or diabetic mortality were noted. The risk of cancer death at any time over the study period was increased by 23% in infertile women compared with the unexposed (adjusted hazard risk, 1.23, 95% confidence interval, 1.10-1.37, P < .001). This effect was predominantly noted in women at an otherwise low risk of cancer mortality who had a 47% increased risk of cancer death (adjusted hazard risk, 1.47, 95% confidence interval, 1.25-1.73, P < .001). While no differences are seen in the risk of death from endometrial or ovarian cancer, the risk of death from breast cancer was more than doubled in infertile women at an otherwise low risk of breast cancer death compared with the unexposed (adjusted hazard risk, 2.64, 95% confidence interval, 1.71-4.08, P < .001). CONCLUSION Infertility is a harbinger of future morbidity and mortality. Infertile women are at an increased risk of all-cause and cancer-related mortality. Consideration of infertility history in health care maintenance presents an opportunity for screening and early intervention for long-term health outcomes.
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Zhu Q, Fu S, Zhang Q, Tian J, Zhao Y, Yao Y. Female Fertility Has a Negative Relationship With Longevity in Chinese Oldest-Old Population: A Cross-Sectional Study. Front Endocrinol (Lausanne) 2020; 11:616207. [PMID: 33613452 PMCID: PMC7887279 DOI: 10.3389/fendo.2020.616207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 12/14/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Despite research efforts in this field for more than a century, the relationship between female fertility and longevity is unclear. This study was designed to investigate this relationship in Chinese oldest-old population. METHODS The China Hainan Centenarian Cohort Study was performed in 18 cities and counties of Hainan. A total of 1,226 females, including 758 centenarian women and 468 women aged 80-99 years, were enrolled in this study. Using a standardized protocol, in-person interviews and blood analyses were conducted by a well-trained research team through home visits. RESULTS Centenarian women had significantly lower number of children (NOC) and higher initial childbearing age (ICA) and last childbearing age (LCA) than women aged 80-99 years (p < 0.05 for all). Multivariate logistic regression analysis showed that NOC and testosterone (T) levels were positively associated with women aged 80-99 years, when centenarian women was considered as reference (p < 0.05 for all). ICA, LCA, and estradiol (E2) levels were negatively associated with women aged 80-99 years, when centenarian women was considered as reference (p < 0.05 for all). CONCLUSIONS The centenarians had crucial characteristics of less and delayed childbearing, indicating a negative relationship between female fertility and longevity in Chinese oldest-old population. Serum E2 levels were positively associated and serum T levels were negatively associated with longevity. The less and late childbearing might be a significant factor of longevity, and successful aging might be promoted by reducing and delaying female childbearing.
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Affiliation(s)
- Qiao Zhu
- Central Laboratory, Hainan Hospital of Chinese People’s Liberation Army General Hospital, Sanya, China
| | - Shihui Fu
- Department of Cardiology, Hainan Hospital of Chinese People’s Liberation Army General Hospital, Sanya, China
| | - Qian Zhang
- Department of Neurology, Hainan Hospital of Chinese People’s Liberation Army General Hospital, Sanya, China
| | - Jinwen Tian
- Department of Cardiology, Hainan Hospital of Chinese People’s Liberation Army General Hospital, Sanya, China
- *Correspondence: Jinwen Tian, ; Yali Zhao, ; Yao Yao,
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese People’s Liberation Army General Hospital, Sanya, China
- *Correspondence: Jinwen Tian, ; Yali Zhao, ; Yao Yao,
| | - Yao Yao
- Center for Healthy Aging and Development Studies, Raissun Institute for Advanced Studies, National School of Development, Peking University, Beijing, China
- Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, United States
- *Correspondence: Jinwen Tian, ; Yali Zhao, ; Yao Yao,
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Feldman B, Orbach-Zinger S, Leventer-Roberts M, Hoshen M, Dagan N, Balicer R, Eidelman LA. Maternal age and cardiovascular and metabolic disease outcomes: a retrospective cohort study using data from population-based electronic medical records. J Matern Fetal Neonatal Med 2018; 33:1853-1860. [PMID: 30278799 DOI: 10.1080/14767058.2018.1531844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: To evaluate whether a woman's age at first birth is associated with cardiovascular risk and metabolic health outcomes (cardiometabolic outcomes) by age 45.Methods: This is a retrospective, population-based cohort study that uses electronic health record data from the largest health fund in Israel. Women aged 34-39 at baseline (2004-2006) free of chronic diseases were identified as nulliparous at baseline and were followed up to 10 years (through 2016). The cohort was divided into three groups based on their age at first birth: younger parturients (ages 35-39), older parturients (ages 40-44), and never had children. The percentage of adverse pregnancy events and cardiometabolic outcomes at age 45 were compared across these three groups as well as to women in the general population. Cardiovascular risk and metabolic health outcomes were defined as: Type 2 diabetes, obesity, hypertension, cardiovascular disease, and Framingham risk score.Methods and results: Out of a group of 126,121 women aged 34-39 at baseline, 9979 were nulliparous and free of comorbidities. Over the course of the follow-up, there were 952 younger parturients and 673 older parturients who had their first birth, and 8354 women who remained persistent nulliparous. While older parturients had more adverse pregnancy events, there was no difference in rates of cardiometabolic outcomes between the two parturient groups, and they both had lower rates than the persistent nulliparous and the general population.Conclusions: Parturients free of major chronic diseases who give birth at a later age do not have increased cardiometabolic outcomes in midlife as compared to a general population of women in a large retrospective cohort. Our results may support clinicians when counseling healthy women who are seeking advice regarding delaying their first pregnancy without a tradeoff on health outcomes.
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Affiliation(s)
- Becca Feldman
- Clalit Research Institute and Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
| | - Sharon Orbach-Zinger
- Department of Anesthesia, Rabin Medical Center, Beilinson Hospital, Petach Tikvah, Israel (affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel)
| | - Maya Leventer-Roberts
- Clalit Research Institute and Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.,Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Moshe Hoshen
- Clalit Research Institute and Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
| | - Noa Dagan
- Clalit Research Institute and Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.,Department of Computer Science, Ben Gurion University, Be'er Sheva, Israel
| | - Ran Balicer
- Clalit Research Institute and Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.,Department of Epidemiology, Ben Gurion University, Be'er Sheva, Israel
| | - Leonid A Eidelman
- Department of Anesthesia, Rabin Medical Center, Beilinson Hospital, Petach Tikvah, Israel (affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel)
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Templeman NM, Murphy CT. Regulation of reproduction and longevity by nutrient-sensing pathways. J Cell Biol 2018; 217:93-106. [PMID: 29074705 PMCID: PMC5748989 DOI: 10.1083/jcb.201707168] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/02/2017] [Accepted: 10/04/2017] [Indexed: 12/23/2022] Open
Abstract
Nutrients are necessary for life, as they are a crucial requirement for biological processes including reproduction, somatic growth, and tissue maintenance. Therefore, signaling systems involved in detecting and interpreting nutrient or energy levels-most notably, the insulin/insulin-like growth factor 1 (IGF-1) signaling pathway, mechanistic target of rapamycin (mTOR), and adenosine monophosphate-activated protein kinase (AMPK)-play important roles in regulating physiological decisions to reproduce, grow, and age. In this review, we discuss the connections between reproductive senescence and somatic aging and give an overview of the involvement of nutrient-sensing pathways in controlling both reproductive function and lifespan. Although the molecular mechanisms that affect these processes can be influenced by distinct tissue-, temporal-, and pathway-specific signaling events, the progression of reproductive aging and somatic aging is systemically coordinated by integrated nutrient-sensing signaling pathways regulating somatic tissue maintenance in conjunction with reproductive capacity.
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Affiliation(s)
- Nicole M Templeman
- Lewis-Sigler Institute for Integrative Genomics and Department of Molecular Biology, Princeton University, Princeton, NJ
| | - Coleen T Murphy
- Lewis-Sigler Institute for Integrative Genomics and Department of Molecular Biology, Princeton University, Princeton, NJ
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Jaspers L, Kavousi M, Erler NS, Hofman A, Laven JS, Franco OH. Fertile lifespan characteristics and all-cause and cause-specific mortality among postmenopausal women: the Rotterdam Study. Fertil Steril 2017; 107:448-456.e1. [DOI: 10.1016/j.fertnstert.2016.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/03/2016] [Accepted: 11/03/2016] [Indexed: 12/17/2022]
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Popkov VA, Silachev DN, Jankauskas SS, Zorova LD, Pevzner IB, Babenko VA, Plotnikov EY, Zorov DB. Molecular and cellular interactions between mother and fetus. Pregnancy as a rejuvenating factor. BIOCHEMISTRY (MOSCOW) 2016; 81:1480-1487. [DOI: 10.1134/s0006297916120099] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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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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