Ren Lei, Guo Peng, Sun Qiao-Mei, Liu Hong, Chen Yu, Huang Ying, Cai Xiao-Jun
Department of Spinal Surgery, Third Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, China.
Department of Hepatobiliary Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, China.
J Obstet Gynaecol Res. 2017 Sep;43(9):1428-1440. doi: 10.1111/jog.13370. Epub 2017 Jun 14.
The association between parity and rheumatoid arthritis (RA) risk has been investigated, but results are controversial. Thus, our aim was to systematically analyze the effect of number of parity on the risk of RA in women.
Relevant published studies were identified using PubMed and embase databases through 1 April 2016. We pooled the relative risks (RR) and 95% confidence intervals (CI) using random-effects models.
In all, 12 studies with a total of 2 497 580 participants and 11 521 RA cases were included. A borderline significant inverse association was observed when we compared parity with nulliparity for RA, with summarized RR = 0.90 (95%CI: 0.79-1.02; I = 58.5%, P = 0.010). In dose-response analysis, we observed a significant nonlinear (P = 0.000) relation between parity number and the risk of RA. Compared with null parity, the pooled RR of RA were 0.89 (95%CI: 0.86-0.93), 0.84 (95%CI: 0.79-0.89), 0.85 (95%CI: 0.79-0.90), 0.88 (95%CI: 0.81-0.95), 0.90 (95%CI: 0.83-0.97), 0.92 (95%CI: 0.84-1.02), and 0.94 (95%CI: 0.83-1.07) for 1, 2, 3, 4, 5, 6, and 7 live births, respectively. Subgroup and sensitivity analyses showed similar associations. No publication bias was found.
The findings from the current meta-analysis indicate that parity was related to decreased risk of RA. The greatest risk reduction appeared when the parity number reached two. Further studies are warranted to confirm our findings.
已对生育次数与类风湿关节炎（RA）风险之间的关联进行了研究，但结果存在争议。因此，我们的目的是系统分析生育次数对女性患RA风险的影响。
通过检索PubMed和Embase数据库，确定截至2016年4月1日发表的相关研究。我们使用随机效应模型汇总相对风险（RR）和95%置信区间（CI）。
共纳入12项研究，总计2497580名参与者和11521例RA病例。当我们将生育次数与未生育进行比较时，观察到RA存在临界显著的负相关，汇总RR = 0.90（95%CI：0.79 - 1.02；I² = 58.5%，P = 0.010）。在剂量反应分析中，我们观察到生育次数与RA风险之间存在显著的非线性关系（P = 0.000）。与未生育相比，1、2、3、4、5、6和7次活产的RA汇总RR分别为0.89（95%CI：0.86 - 0.93）、0.84（95%CI：0.79 - 0.89）、0.85（95%CI：0.79 - 0.90）、0.88（95%CI：0.81 - 0.95）、0.90（95%CI：0.83 - 0.97）、0.92（95%CI：0.84 - 1.02）和0.94（95%CI：0.83 - 1.07）。亚组分析和敏感性分析显示了相似的关联。未发现发表偏倚。
当前荟萃分析的结果表明，生育次数与RA风险降低有关。生育次数达到2次时，风险降低最为显著。需要进一步的研究来证实我们的发现。
