Cohen Nathan J, Rifas-Shiman Sheryl L, Soria-Contreras Diana C, Perng Wei, Hivert Marie-France, Oken Emily, Chavarro Jorge E, Minguez-Alarcon Lidia
From the Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, NY.
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
Menopause. 2025 Apr 1;32(4):323-330. doi: 10.1097/GME.0000000000002495. Epub 2024 Dec 24.
Reproductive history may help identify women at higher risk for experiencing menopausal symptoms. We hypothesized that gestation length and offspring birthweight for gestational age z-scores would be associated with menopausal symptoms and age at natural menopause in midlife among women in a longitudinal prebirth cohort.
Among 691 women enrolled in pregnancy and followed to midlife, we examined associations of gestation length and offspring birthweight for gestational age z-score at the index pregnancy with total menopausal symptoms assessed with the 11-item Menopause Rating Scale (MRS) using linear regression models, with individual menopausal symptoms using binomial regression models with a log link function, and with age at natural menopause using Cox proportional hazards models. We adjusted all models for age at enrollment, education, parity, annual household income, and prepregnancy body mass index.
Mean (SD) MRS total score was 7.9 (5.8) points at age 52.1 (3.8) years, and mean (SD) age at natural menopause was 50.8 (3.7) years. We observed null associations of gestation length (β = -0.07 points per week, 95% confidence interval [CI] = -0.32 to 0.18) and birthweight for gestational age z-score (β = 0.16 points per z-score, 95% CI = -0.31 to 0.63) with the MRS total score in adjusted models. We also observed null associations of gestation length (adjusted hazards ratio = 0.99 per week, 95% CI = 0.94-1.06) and birthweight for gestational age z-score (adjusted hazards ratio = 1.06 per z-score, 95% CI = 0.94-1.19) with age of onset of natural menopause.
Birth outcomes were not associated with total menopause symptom scores or age at natural menopause.
生育史可能有助于识别出现更年期症状风险较高的女性。我们假设,在一个纵向产前队列研究的中年女性中,孕周和根据胎龄Z评分得出的子代出生体重与更年期症状及自然绝经年龄有关。
在691名孕期入组并随访至中年的女性中,我们使用线性回归模型,研究首次妊娠时的孕周和根据胎龄Z评分得出的子代出生体重与使用11项更年期评定量表(MRS)评估的更年期症状总分之间的关联;使用带有对数链接函数的二项回归模型,研究其与个体更年期症状之间的关联;使用Cox比例风险模型,研究其与自然绝经年龄之间的关联。我们在所有模型中对入组年龄、教育程度、产次、家庭年收入和孕前体重指数进行了调整。
在52.1(3.8)岁时,MRS总分的均值(标准差)为7.9(5.8)分,自然绝经的平均(标准差)年龄为50.8(3.7)岁。在调整后的模型中,我们观察到孕周(β=-0.07分/周,95%置信区间[CI]=-0.32至0.18)和根据胎龄Z评分得出的出生体重(β=0.16分/Z评分,95%CI=-0.31至0.63)与MRS总分之间无关联。我们还观察到孕周(调整后的风险比=0.99/周,95%CI=0.94-1.06)和根据胎龄Z评分得出的出生体重(调整后的风险比=1.06/Z评分,95%CI=0.94-1.19)与自然绝经年龄之间无关联。
出生结局与更年期症状总分或自然绝经年龄无关。