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初育年龄与产妇长期死亡率:大崎队列研究。

Age at first birth and long-term mortality for mothers: the Ohsaki cohort study.

机构信息

Juntendo University Faculty of Health Sciences and Nursing, 3-7-33 Omiyacho, Mishima, Shizuoka, 411-8787, Japan.

Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan.

出版信息

Environ Health Prev Med. 2017 Apr 4;22(1):24. doi: 10.1186/s12199-017-0631-x.

Abstract

BACKGROUND

Although maternal age at first birth has been rising in many developed countries, its long-term effects on the health of the mothers themselves are unclear. In this study, we investigated the relationship between maternal age at first birth and long-term mortality.

METHODS

We conducted a cohort study of 20,624 parous Japanese women aged between 40 and 79 years in 1994 and followed up their survival for 14 years. Based on maternal age at first birth, the women were divided into four groups: ≤19 years, 20-24 years, 25-29 years, and ≥30 years. Using the 20-24 years group as a reference, hazards ratios (HRs) for all-cause and cause-specific mortality were calculated.

RESULTS

Multivariate HRs for all-cause mortality were 1.17 in the ≤19 years group, 1.09 in the 25-29 years group, and 1.33 in the ≥30 years group. A U-shaped relationship was apparent between maternal age at first birth and mortality. This relationship was also observed for mortality attributable to cancer, cardiovascular disease and other diseases. This U-shaped relationship was observed only for women born before 1935 and the birth year of the first child before 1960.

CONCLUSION

A U-shaped relationship was apparent between maternal age at first birth and mortality. As maternal age at first birth is rising worldwide, the risk it imposes appears to have significance in the context of public health.

摘要

背景

尽管许多发达国家的初产妇年龄一直在上升,但初产妇年龄对母亲自身健康的长期影响尚不清楚。本研究旨在调查初产妇年龄与长期死亡率之间的关系。

方法

我们对 1994 年年龄在 40 至 79 岁之间的 20624 名经产妇进行了队列研究,并随访了她们 14 年的生存情况。根据初产妇年龄,将这些女性分为四组:≤19 岁、20-24 岁、25-29 岁和≥30 岁。以 20-24 岁组为参照,计算了全因和死因特异性死亡率的危害比(HR)。

结果

多变量 HR 显示,≤19 岁组的全因死亡率为 1.17,25-29 岁组为 1.09,≥30 岁组为 1.33。初产妇年龄与死亡率之间呈明显的 U 形关系。这种关系也存在于归因于癌症、心血管疾病和其他疾病的死亡率中。这种 U 形关系仅见于 1935 年以前出生的女性和 1960 年以前生育第一胎的女性。

结论

初产妇年龄与死亡率之间存在明显的 U 形关系。随着全球初产妇年龄的上升,其带来的风险在公共卫生方面似乎具有重要意义。

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