Department of Biostatistics and Epidemiology, University of Massachusetts-Amherst, 715 North Pleasant Street, Amherst, MA, 01003, USA.
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ, 85724, USA.
BMC Womens Health. 2024 Oct 3;24(1):546. doi: 10.1186/s12905-024-03384-6.
Women who reach menarche and menopause at earlier ages have been shown to be at increased risk for numerous conditions including cardiovascular disease, cancer, depression, and obesity; however, risk factors for earlier ages of menarche and menopause are not fully understood. Therefore, we aimed to perform a retrospective investigation of the associations between a personal birthweight and/or being born preterm and the age of and menarche and menopause and related events in the Women's Health Initiative, a large, racially and ethnically diverse cohort of postmenopausal women.
At study entry, women reported their birthweight by category (< 6 lbs., 6-7 lbs. 15 oz, 8-9 lbs. 15 oz, or ≥ 10 lbs.) and preterm birth status (4 or more weeks premature). Ages at events related to menarche and menopause were also self-reported. Linear regression and logistic regression models were used to estimate unadjusted and adjusted effect estimates (β) and odds ratios (OR), respectively (n ≤ 86,857). Individuals born preterm were excluded from all birthweight analyses.
After adjustments, individuals born weighing < 6lbs. were more likely to reach natural menopause at an earlier age (adjusted β=-0.361, SE = 0.09, P = < 0.001) and have a shorter reproductive window (adjusted β = -0.287, SE = 0.10, p < 0.004) compared to individuals weighing 6-7 lbs. 15 oz. Individuals born preterm were also more likely to reach natural menopause at an earlier age (adjusted β=-0.506, SE = 0.16, P = 0.001) and have a shorter reproductive window (adjusted β = -0.418, SE = 0.17, p < 0.006).
These findings raise concerns that, as more preterm and low birthweight individuals survive to adulthood, the prevalence of earlier-onset menarche and menopause may increase. Clinical counseling and interventions aimed at reducing the incidence of preterm and low birthweight births, as well as intensification of lifestyle modifications to reduce CVD risk among women with these early-life risk factors, should be prioritized.
有研究表明，初潮和绝经年龄较早的女性患多种疾病的风险增加，包括心血管疾病、癌症、抑郁症和肥胖症；然而，初潮和绝经年龄较早的风险因素尚未完全阐明。因此，我们旨在对妇女健康倡议（一项大型、种族和族裔多样化的绝经后妇女队列研究）中个人出生体重和/或早产与初潮和绝经年龄以及相关事件之间的关联进行回顾性研究。
在研究开始时，女性通过类别报告了她们的出生体重（<6 磅、6-7 磅 15 盎司、8-9 磅 15 盎司或≥10 磅）和早产状况（提前 4 周或以上）。与初潮和绝经相关的年龄也由女性自我报告。线性回归和逻辑回归模型分别用于估计未调整和调整后的效应估计值（β）和比值比（OR）（n≤86857）。所有与出生体重相关的分析均排除了早产儿。
调整后，出生体重<6 磅的个体更有可能更早地进入自然绝经（调整后的β=-0.361，SE=0.09，P<0.001），并且生育期更短（调整后的β=-0.287，SE=0.10，p<0.004），与体重为 6-7 磅 15 盎司的个体相比。早产儿也更有可能更早地进入自然绝经（调整后的β=-0.506，SE=0.16，P=0.001），并且生育期更短（调整后的β=-0.418，SE=0.17，p<0.006）。
这些发现令人担忧的是，随着越来越多的早产儿和低出生体重的个体存活到成年期，初潮和绝经年龄较早的发病率可能会增加。应该优先考虑临床咨询和干预措施，以减少早产和低出生体重的发生率，以及加强生活方式的改变，以降低有这些早期生命风险因素的女性患心血管疾病的风险。
