Sun Ming-Hui, Wen Zhao-Yan, Wang Ran, Gao Chang, Yin Jia-Li, Chang Yu-Jiao, Wu Qi-Jun, Zhao Yu-Hong
Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China.
Front Med (Lausanne). 2022 Jul 12;9:926944. doi: 10.3389/fmed.2022.926944. eCollection 2022.
Epidemiological studies have provided inconsistent evidence of the association between parity and metabolic syndrome (MetS) risk. We conducted this first systematic review and meta-analysis to comprehensively and precisely quantify this topic.
Comprehensive searches of PubMed, Embase, and the Web of Science databases were conducted to identify observational studies of the association between parity and MetS risk up to 30 January 2022. Study inclusion, data extraction, and quality assessment were checked and reviewed by two investigators independently. Random-effects models were applied to estimate pooled odds ratios (ORs) and 95% CIs. This study has been registered with PROSPERO.
Two high-quality cohorts and thirteen medium-quality cross-sectional studies involving 62,095 women were finally included. Compared with the nulliparous, the pooled OR of MetS for the ever parity was 1.31 (95% CI = 0.91-1.88, = 72.6%, = 3). Compared with the lowest parity number, the pooled OR of MetS for the highest parity number was 1.38 (95% CI = 1.22-1.57, = 60.7%, = 12). For the dose-response analysis, the pooled OR of MetS for each increment of one live birth was 1.12 (95% CI = 1.05-1.19, = 78.6%, = 6). These findings were robust across subgroups and sensitivity analyses. No evidence of heterogeneity between subgroups was indicated by meta-regression analyses.
The findings suggested that parity was associated with an increased risk of MetS. A sufficient number of large prospective cohort studies are required to fully verify our findings.
[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022307703].
流行病学研究提供的关于生育次数与代谢综合征（MetS）风险之间关联的证据并不一致。我们开展了这项首次系统性综述和荟萃分析，以全面、精确地量化这一主题。
对PubMed、Embase和Web of Science数据库进行全面检索，以确定截至2022年1月30日的关于生育次数与MetS风险之间关联的观察性研究。由两名研究者独立检查和审查研究纳入、数据提取及质量评估情况。采用随机效应模型估计合并优势比（OR）和95%可信区间（CI）。本研究已在国际前瞻性系统评价注册库（PROSPERO）登记。
最终纳入两项高质量队列研究和13项中等质量横断面研究，涉及62,095名女性。与未生育女性相比，曾经生育女性患MetS的合并OR为1.31（95%CI = 0.91 - 1.88，I² = 72.6%，P = 3）。与最低生育次数相比，最高生育次数女性患MetS的合并OR为1.38（95%CI = 1.22 - 1.57，I² = 60.7%，P = 12）。在剂量反应分析中，每增加一次活产，患MetS的合并OR为1.12（95%CI = 1.05 - 1.19，I² = 78.6%，P = 6）。这些发现在各亚组和敏感性分析中均稳健。Meta回归分析未显示亚组间存在异质性证据。
研究结果表明，生育次数与MetS风险增加有关。需要开展足够数量的大型前瞻性队列研究来充分验证我们的研究结果。
