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高胎次与欧洲高生育力人群中女性死亡率降低相关:来自爱尔兰的研究结果。

Higher Parity Is Associated With Lower Mortality in a European Population of Women With High Fertility: Results From Ireland.

机构信息

The Irish Longitudinal Study on Ageing (TILDA), Lincoln Gate, Trinity College Dublin, Ireland.

Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.

出版信息

J Gerontol A Biol Sci Med Sci. 2021 Aug 13;76(9):1571-1578. doi: 10.1093/gerona/glaa323.

Abstract

Research has often found a U- or J-shaped association between parity and mortality. Many researchers have suggested repeated pregnancy, childbirth, and lactation taxes the body beyond a certain parity level. Available research has concentrated on populations with controlled fertility or historic populations. Ireland presents an opportunity to explore these associations in a modern sample with high fertility. We use data from the Irish Longitudinal Study on Ageing (TILDA) to test whether parity is associated with mortality in women aged 50 years or over (n = 4177). We use Cox proportional hazards models to model survival and adjust for demographics and early life circumstances. We test whether a number of health characteristics mediate these effects. Models were also stratified by birth cohort to test possible cohort effects. Higher parity was associated with lower risk of mortality, even after adjustment for early life and socioeconomic circumstances. This effect was not mediated by current health characteristics. The effects were largely driven by those born between 1931 and 1950. Increasing parity is associated with decreasing mortality risk in this sample. The effects of parity could not be explained through any of the observed health characteristics. These findings are in contrast to much of the literature on this question in similar populations. Lack of fertility control in Ireland may have "selected" healthier women into high parity. Social explanations for these associations should be further explored.

摘要

研究经常发现生育次数与死亡率之间呈 U 型或 J 型关联。许多研究人员认为,多次怀孕、分娩和哺乳会使身体在一定生育次数后承受过度的负担。现有的研究集中在生育受到控制或历史人口上。爱尔兰为在具有高生育率的现代样本中探索这些关联提供了机会。我们使用爱尔兰老龄化纵向研究(TILDA)的数据来检验生育次数与 50 岁及以上女性的死亡率之间的关系(n=4177)。我们使用 Cox 比例风险模型来模拟生存,并调整人口统计学和早期生活环境。我们检验了一些健康特征是否会影响这些关联。还按出生队列对模型进行分层,以检验可能的队列效应。较高的生育次数与较低的死亡率风险相关,即使在调整了早期生活和社会经济环境后也是如此。这种关联不受当前健康特征的影响。这种影响主要是由 1931 年至 1950 年出生的人驱动的。在这个样本中,生育次数的增加与死亡率风险的降低有关。生育次数的影响不能通过观察到的任何健康特征来解释。这些发现与类似人群中关于这个问题的大部分文献相反。爱尔兰缺乏生育控制可能会将更健康的女性“筛选”到高生育次数的行列中。应该进一步探讨这些关联的社会解释。

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