Okyay Duygu Ozkale, Okyay Emre, Dogan Erbil, Kurtulmus Secil, Acet Ferruh, Taner Cuneyt Eftal
Aegean Maternity and Women's Health Hospital, Department of Obstetrics and Gynecology, Izmir, Turkey.
Dokuz Eylul University School of Medicine, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Izmir, Turkey.
Maturitas. 2013 Mar;74(3):270-5. doi: 10.1016/j.maturitas.2012.12.014. Epub 2013 Jan 24.
This study investigated the effects of parity and age at first pregnancy and breast-feeding, as well as duration of BF for total and per child on postmenopausal osteoporosis.
The study was conducted among 542 cases who were divided based on the presence or absence of osteoporosis. Patients were separated according to their first pregnancy and breast-feeding age as before or after 27 years. Osteoporosis was defined as a T score of -2.5 or lower.
Parity, age at first pregnancy and breast-feeding, breast-feeding period for total and average duration per child according to a questionnaire were assessed.
Osteoporosis group had significantly lower parity compared to non-osteoporosis group. The age at first pregnancy and breast-feeding<27 age were significantly more frequent in osteoporosis group. They also had prolonged breast-feeding period. Women who had a breast-feeding period per child>1 year under age 27 was higher in osteoporosis group. In multivariate analysis, women who breast-fed>1 year per child had the highest risk for osteoporosis (odds ratio: 12.92; 95% confidence interval, 3.1-52.6) and osteoporosis risk for women who breast-fed>1 year per child under age 27 was 7.1. Increased parity was associated with a significant protective effect for osteoporosis.
Extended breast-feeding period per child>1 year is the highest risk factor for osteoporosis independent of first breast-feeding age. However, high parity has a protective effect.
本研究调查了产次、首次妊娠和哺乳时的年龄，以及总哺乳期和每个孩子的哺乳期对绝经后骨质疏松症的影响。
该研究在542例患者中进行，这些患者根据是否患有骨质疏松症进行分组。患者按照首次妊娠和哺乳年龄在27岁之前或之后进行区分。骨质疏松症的定义为T值≤-2.5。
根据问卷评估产次、首次妊娠和哺乳时的年龄、总哺乳期以及每个孩子的平均哺乳期。
与非骨质疏松症组相比，骨质疏松症组的产次显著更低。骨质疏松症组中首次妊娠和哺乳年龄<27岁的情况明显更为常见。他们的哺乳期也更长。骨质疏松症组中每个孩子哺乳期>1年且年龄<27岁的女性比例更高。在多变量分析中，每个孩子母乳喂养>1年的女性患骨质疏松症的风险最高（优势比：12.92；95%置信区间，3.1 - 52.6），而每个孩子母乳喂养>1年且年龄<27岁的女性患骨质疏松症的风险为7.1。产次增加与对骨质疏松症有显著的保护作用相关。
每个孩子延长哺乳期>1年是独立于首次哺乳年龄的骨质疏松症的最高风险因素。然而，高产次具有保护作用。
