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活产婴儿数量、生育年龄、生育间隔与痴呆风险:一项基于人群的 253611 名英国女性的队列研究。

Number of Live Births, Age at the Time of Having a Child, Span of Births and Risk of Dementia: A Population-Based Cohort Study of 253,611 U.K. Women.

机构信息

Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.

Department of Social Medicine, Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.

出版信息

J Womens Health (Larchmt). 2023 Jun;32(6):680-692. doi: 10.1089/jwh.2022.0396. Epub 2023 Apr 13.

Abstract

The association between birth-related factors and dementia is unclear. We aimed to investigate their association and subsequent risk of dementia in a large-scale follow-up prospective study. This population-based cohort study used data from U.K. Biobank (2006-2010), and the median follow-up was 12.0 years. Multivariable-adjusted Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) between number of children, age of first live birth, age of last live birth, span of births, and dementia. Restricted cubic spline models were used to quantify dose-response relationships. A total of 253,611 women with mean age (standard deviation) of 56.3 (8.0) years were included. Compared with women with no child, women who had three or more children and first birth at age before 25 years, had elevated risk of all-cause dementia (HR: 1.30, 95% CI: 1.10-1.54), Alzheimer's disease (AD; 1.21, 1.00-1.46), and vascular dementia (VD; 1.59, 1.19-2.13). Also, women with three or more children and the last birth at age before 30 years, had increased risk of all-cause dementia (1.33, 1.11-1.59), AD (1.27, 1.03-1.57), and VD (1.55, 1.12-2.13). Moreover, women who had three or more children in <7 years, had an increased risk of all-cause dementia (1.25, 1.04-1.49). Dose-response relationship showed a lowest risk of dementia at having two children, and having three or more children in 7-9 years. Number of children, age of births, and span of births were all related to risk of dementia. These findings may help developing fertility policies or dementia prevention programs.

摘要

生育相关因素与痴呆的关系尚不清楚。我们旨在通过一项大规模的随访前瞻性研究来调查它们之间的关联及其随后发生痴呆的风险。这项基于人群的队列研究使用了英国生物库(2006-2010 年)的数据,中位随访时间为 12.0 年。多变量调整的 Cox 比例风险模型用于估计儿童数量、首次活产年龄、末次活产年龄、生育间隔与痴呆之间的风险比(HR)和 95%置信区间(CI)。受限立方样条模型用于量化剂量-反应关系。共纳入 253611 名年龄(标准差)为 56.3(8.0)岁的女性。与无子女的女性相比,生育 3 个或更多子女且首次生育年龄<25 岁、首次生育年龄<25 岁的女性,全因痴呆(HR:1.30,95%CI:1.10-1.54)、阿尔茨海默病(AD;1.21,1.00-1.46)和血管性痴呆(VD;1.59,1.19-2.13)的风险升高。此外,生育 3 个或更多子女且末次生育年龄<30 岁的女性,全因痴呆(1.33,1.11-1.59)、AD(1.27,1.03-1.57)和 VD(1.55,1.12-2.13)的风险增加。此外,生育间隔<7 年生育 3 个或更多子女的女性,全因痴呆的风险增加(1.25,1.04-1.49)。剂量-反应关系显示生育 2 个孩子的痴呆风险最低,生育 3 个或更多孩子且生育间隔为 7-9 年的痴呆风险最低。儿童数量、生育年龄和生育间隔均与痴呆风险相关。这些发现可能有助于制定生育政策或预防痴呆的计划。

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