Raghuwanshi Neelam Singh, Baraiya Neha, Sharma Sonendra Kumar, Gupta Vishnu Kumar, Nema Parul
Department of Obstetrics and Gynaecology, SRVS Medical College, Shivpuri, Madhya Pradesh, India.
Department of Obstetrics and Gynaecology, Shrimant Rajmata Vijayaraje Scindia Medical College and Hospital, Shivpuri, Madhya Pradesh, India.
J Orthop Case Rep. 2025 Sep;15(9):348-352. doi: 10.13107/jocr.2025.v15.i09.6122.
Osteoarthritis (OA), a leading cause of disability among elderly women, is influenced by both biological and lifestyle factors. Among these, reproductive history, especially parity, has emerged as a potential contributor. Hormonal fluctuations, weight gain during pregnancy, and cumulative mechanical stress on joints may predispose parous women to OA in later life. Despite increasing attention to this association, the extent to which parity contributes to OA risk in Indian women remains insufficiently explored.
This retrospective analytical study was conducted at a tertiary care hospital in India and included 234 postmenopausal women aged ≥60 years attending outpatient departments. Parity status was obtained from hospital records and patient interviews. Participants were categorized into three groups based on parity: nulliparous, low parity (1-3 children), and grand multiparous (≥4 children). The diagnosis of OA was confirmed using clinical criteria and radiographic evidence. Data were analyzed using the Statistical Package for the Social Sciences v25.0 with the Chi-square test. A P < 0.05 was considered statistically significant.
A total of 234 postmenopausal women with knee OA were included in the study. The mean age was 67.4 ± 5.2 years, with a mean BMI of 26.8 ± 3.4 kg/m2 and a mean postmenopausal duration of 17.3 ± 6.5 years. Diabetes mellitus and hypertension were present in 33.3% and 43.6% of participants, respectively. Based on the Kellgren-Lawrence grading, 46.2% had Grade 2 OA, 38.5% had Grade 3 OA, and 15.4% had Grade 4 OA. Regarding parity, 7.7% were nulliparous, 17.9% had low parity (1-2), 42.3% had moderate parity (3-4), and 32.1% were grand multiparous (≥5). A significant association was found between higher parity and increased severity of OA (P < 0.01), with grand multiparous women showing the highest proportion of Grade 4 OA (24.0%).
A significant positive correlation was observed between higher parity and the risk of developing OA in elderly women. Grand multiparity may serve as an independent risk factor for OA and should be considered in preventive strategies and early screening programs.
骨关节炎（OA）是老年女性致残的主要原因之一，受生物学和生活方式因素的影响。其中，生育史，尤其是产次，已成为一个潜在因素。激素波动、孕期体重增加以及关节累积的机械应力可能使经产妇在晚年易患骨关节炎。尽管对这种关联的关注度不断提高，但产次对印度女性骨关节炎风险的影响程度仍未得到充分研究。
这项回顾性分析研究在印度一家三级护理医院进行，纳入了234名年龄≥60岁的绝经后门诊女性。产次状况通过医院记录和患者访谈获得。参与者根据产次分为三组：未生育、低产次（1 - 3个孩子）和多产次（≥4个孩子）。骨关节炎的诊断依据临床标准和影像学证据确定。数据使用社会科学统计软件包v25.0进行分析，并采用卡方检验。P < 0.05被认为具有统计学意义。
本研究共纳入234名患有膝骨关节炎的绝经后女性。平均年龄为67.4 ± 5.2岁，平均体重指数为26.8 ± 3.4 kg/m²，平均绝经持续时间为17.3 ± 6.5年。分别有33.3%和43.6%的参与者患有糖尿病和高血压。根据凯尔格伦 - 劳伦斯分级，46.2%的患者为2级骨关节炎，38.5%为3级骨关节炎，15.4%为4级骨关节炎。关于产次，7.7%未生育，17.9%为低产次（1 - 2个孩子），42.3%为中产次（3 - 4个孩子），32.1%为多产次（≥5个孩子）。发现产次较高与骨关节炎严重程度增加之间存在显著关联（P < 0.01），多产次女性中4级骨关节炎的比例最高（24.0%）。
观察到老年女性产次较高与患骨关节炎风险之间存在显著正相关。多产次可能是骨关节炎的独立危险因素，应在预防策略和早期筛查项目中予以考虑。
