Braun School of Public Health and Community Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel.
Department of Obstetrics and Gynecology, Hadassah Medical Center, Hebrew University, Jerusalem, Israel.
Ann Epidemiol. 2015 Jun;25(6):387-91. doi: 10.1016/j.annepidem.2014.12.002. Epub 2015 Jan 24.
To examine the association between the mother's age at last birth and maternal long-term survival.
Data from three national censuses (1972, 1983, and 1995) and national birth and death records (1972-2009) were used to examine the association between age at last birth and mortality while accounting for potential confounders, such as parity. Age-adjusted mortality rates and Cox proportional hazard models were used in the analysis.
A total of 887 women who delivered their last child after 45 years of age were identified from among 178,507 women (1,592,379 person-years). Age-adjusted mortality rates from 55 years of age were highest for childless women (9.2 per 1000) and decreased linearly (P < .001) for parous women with increased age at last birth (5.2 per 1000 for women aged ≥45 years at last birth). In models adjusted for age at first birth and parity, mortality risks were lowest among parous women with late-age births (≥45 years) compared with parous women with their last births before 35 years of age (hazard ratio, 0.58; 95% confidence interval, 0.40-0.86).
This study provides new empirical evidence that late-age births are associated with maternal longevity, although a direct causal relation cannot be established with the information available.
探讨母亲最后一次生育时的年龄与产妇长期生存之间的关系。
利用三次全国人口普查（1972 年、1983 年和 1995 年）和全国出生和死亡记录（1972-2009 年）的数据，在考虑到潜在混杂因素（如生育次数）的情况下，考察最后一次生育年龄与死亡率之间的关系。采用年龄调整死亡率和 Cox 比例风险模型进行分析。
在 178507 名女性（1592379 人年）中，共确定了 887 名最后一次生育年龄超过 45 岁的女性。55 岁时，从未生育过的女性死亡率最高（9.2/1000），随着最后一次生育年龄的增加，生育次数较多的女性死亡率呈线性下降（9.2/1000 至最后一次生育年龄≥45 岁的女性 5.2/1000）。在调整初产年龄和生育次数的模型中，与 35 岁前最后一次生育的生育次数较多的女性相比，晚育（≥45 岁）的生育次数较多的女性的死亡风险最低（危险比，0.58；95%置信区间，0.40-0.86）。
本研究提供了新的经验证据，表明晚育与产妇长寿有关，但根据现有资料尚不能确立直接的因果关系。
