Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China.
School of Public Health, Fujian Medical University, Fuzhou, China.
Front Public Health. 2023 Feb 20;11:1090549. doi: 10.3389/fpubh.2023.1090549. eCollection 2023.
Multimorbidity has become an important public health problem in China, especially among middle-aged and elderly women. Few studies have been reported on the association between multimorbidity and female fertility, which is an important stage in the life course. This study aimed to explore the association between multimorbidity and fertility history among middle-aged and elderly women in China.
Data from 10,182 middle-aged and elderly female participants in the China Health and Retirement Longitudinal Study (CHARLS) in 2018 were used in this study. Multimorbidity was defined as the presence of at least two or more chronic conditions. Logistic regression analysis, negative binomial regression analysis, and restrictive cubic splines (RCSs) were used to analyze the relationship between female fertility history and multimorbidity or the number of chronic conditions. Multivariable linear regression was used to analyze the relationship between female fertility history and multimorbidity pattern factor scores.
The results of this study showed that high parity and early childbearing were significantly associated with an increased risk of multimorbidity and an increased number of chronic conditions among middle-aged and elderly women in China. Late childbearing was significantly associated with reduced risk of multimorbidity and lessened diseases. Parity and age of first childbirth were significantly correlated with the odds of multimorbidity. The association between fertility history and multimorbidity was found to be influenced by age and urban-rural dual structure. Women with high parity tend to have higher factor scores of cardiac-metabolic, visceral-arthritic, and respiratory-psychiatric patterns. Women with early childbearing tended to have higher factor scores of the visceral-arthritic pattern and those with late childbearing tended to have lower factor scores of the cardiac-metabolic pattern.
Fertility history has a significant effect on multimorbidity in the middle and later lives of Chinese women. This study is of great importance for reducing the prevalence of multimorbidity among Chinese women through their life course and promoting health during their middle and later lives.
在中国，多种疾病已经成为一个重要的公共卫生问题，尤其是在中年和老年女性中。关于多种疾病与女性生育能力之间的关系，目前报道较少，而生育能力是生命历程中的一个重要阶段。本研究旨在探讨中国中年和老年女性中多种疾病与生育史之间的关系。
本研究使用了 2018 年中国健康与退休纵向研究（CHARLS）中 10182 名中年和老年女性参与者的数据。将至少两种或两种以上的慢性疾病定义为多种疾病。使用逻辑回归分析、负二项回归分析和限制性三次样条（RCS）分析女性生育史与多种疾病或慢性疾病数量之间的关系。使用多变量线性回归分析女性生育史与多种疾病模式因子评分之间的关系。
研究结果表明，在中国的中年和老年女性中，高生育次数和早育与多种疾病和慢性疾病数量的增加风险显著相关，晚育与多种疾病和疾病减少的风险显著相关。生育次数和初育年龄与多种疾病的发生几率显著相关。生育史与多种疾病之间的关系受到年龄和城乡二元结构的影响。生育次数高的女性往往具有较高的心脏代谢、内脏关节炎和呼吸精神病模式因子评分，早育的女性往往具有较高的内脏关节炎模式因子评分，晚育的女性往往具有较低的心脏代谢模式因子评分。
生育史对中国女性中晚年的多种疾病有显著影响。本研究对于通过女性的生命历程降低中国女性多种疾病的发病率，促进其中晚年健康具有重要意义。
