San Diego State University/University of California San Diego Joint Doctoral Program in Public Health (Epidemiology), San Diego, CA.
Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA.
Menopause. 2019 Jul;26(7):750-757. doi: 10.1097/GME.0000000000001318.
The aim of the study was to examine the association of pregnancy history with trajectories of cognitive function in older women.
Participants were 1,025 women (mean age = 73.1 ± 9.6 y) enrolled in the Rancho Bernardo Study who attended a clinic visit between 1988 and 1992, when pregnancy history (ever pregnant, number of pregnancies, ages at first and last pregnancy) was recorded and cognitive function was assessed with a battery of four tests repeated up to 7 times through 2016. Linear mixed-effects regression models were used to examine the association between pregnancy history and longitudinal change in cognitive function.
Overall, 77% of women had at least one pregnancy; number of pregnancies ranged from 1 to 14 (mean = 2.9 ± 1.7). Ages at first and last pregnancy ranged from 16 to 44 years (mean = 24.9 ± 4.7) and 16 to 49 years (mean = 30.7 ± 5.5), respectively. Of 16 associations tested (4 pregnancy exposures by 4 cognitive tests), one was statistically significant without correction for multiple comparisons. Women who reported ever being pregnant recalled 0.12 fewer words on the Buschke Selective Reminding Test for every year increase in age than women who had never been pregnant (P = 0.05). No other significant associations of pregnancy history with cognitive decline were observed.
Our results show no clinically meaningful long-term influence of pregnancy history on age-related change in cognitive function. These reassuring findings suggest childbearing decisions and timing will not affect cognitive function in older age.
本研究旨在探讨妊娠史与老年女性认知功能轨迹的关系。
参与者为 1025 名女性（平均年龄为 73.1±9.6 岁），她们参加了 1988 年至 1992 年期间在 Rancho Bernardo 研究中心进行的一次临床访视，当时记录了妊娠史（曾怀孕、怀孕次数、首次和末次妊娠年龄），并使用四项测试的测试结果评估认知功能，这些测试结果通过线性混合效应回归模型进行分析，直至 2016 年重复了 7 次。
总体而言，77%的女性至少怀孕过一次；怀孕次数从 1 次到 14 次不等（平均值为 2.9±1.7）。首次和末次妊娠年龄从 16 岁到 44 岁（平均值为 24.9±4.7）和 16 岁到 49 岁（平均值为 30.7±5.5）不等。在测试的 16 个关联中（4 个妊娠暴露与 4 个认知测试），有一个在未进行多次比较校正的情况下具有统计学意义。与从未怀孕的女性相比，报告曾怀孕的女性在 Buschke 选择性提醒测试中回忆的单词数每增加 1 岁会减少 0.12 个（P=0.05）。没有发现妊娠史与认知能力下降之间存在其他显著关联。
我们的研究结果表明，妊娠史对认知功能与年龄相关的变化没有明显的长期影响。这些令人安心的发现表明，生育决策和时间不会影响老年时的认知功能。
