Cumming R G, Klineberg R J
Department of Public Health A27 University of Sydney, Australia.
Int J Epidemiol. 1993 Aug;22(4):684-91. doi: 10.1093/ije/22.4.684.
The objective of this population-based case-control study was to clarify the relationships between parity, breastfeeding and ages at menarche and menopause and the risk of hip fracture among elderly women. The study base comprised women aged 65 years and over living in a defined region in Sydney, Australia, during 1990-1991. Cases (n = 174) were recruited from 12 hospitals and controls (n = 137) were selected using an area probability sampling method, with additional sampling from nursing homes. The age- and proxy-adjusted odds ratio (OR) comparing parous women who had never breastfed with nulliparous women was 2.11 (95% confidence interval (CI): 0.85-5.25). Among parous women, the age- and proxy-adjusted OR for ever versus never breastfeeding was 0.47 (95% CI: 0.22-0.99). There was a dose-response relationship between average duration of breastfeeding per child and risk of hip fracture (test for trend: P < 0.01). Age at menopause and age at menarche were only weakly associated with hip fracture risk. This study suggests that breastfeeding may protect parous women against hip fracture in old age.
这项基于人群的病例对照研究的目的是阐明生育次数、母乳喂养以及初潮和绝经年龄与老年女性髋部骨折风险之间的关系。研究对象包括1990 - 1991年期间居住在澳大利亚悉尼特定区域的65岁及以上女性。病例(n = 174)从12家医院招募,对照(n = 137)采用区域概率抽样方法选取,并从养老院进行额外抽样。从未母乳喂养的经产妇与未生育女性相比,年龄和代理因素调整后的比值比(OR)为2.11(95%置信区间(CI):0.85 - 5.25)。在经产妇中,曾经母乳喂养与从未母乳喂养相比,年龄和代理因素调整后的OR为0.47(95% CI:0.22 - 0.99)。每个孩子的平均母乳喂养时长与髋部骨折风险之间存在剂量反应关系(趋势检验:P < 0.01)。绝经年龄和初潮年龄与髋部骨折风险的关联较弱。这项研究表明,母乳喂养可能会保护经产妇在老年时免受髋部骨折。