Female reproductive histories and the risk of chronic obstructive pulmonary disease.

Autor:	Liang C; School of Public Health, The University of Queensland, Brisbane, Queensland, Australia., Chung HF; School of Public Health, The University of Queensland, Brisbane, Queensland, Australia., Dobson A; School of Public Health, The University of Queensland, Brisbane, Queensland, Australia., Sandin S; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden., Weiderpass E; International Agency for Research on Cancer, World Health Organization, Lyon, France., Mishra GD; School of Public Health, The University of Queensland, Brisbane, Queensland, Australia g.mishra@uq.edu.au.
Jazyk:	angličtina
Zdroj:	Thorax [Thorax] 2024 May 20; Vol. 79 (6), pp. 508-514. Date of Electronic Publication: 2024 May 20.
DOI:	10.1136/thorax-2023-220388
Abstrakt:	Background: Female reproductive factors may influence the development of chronic obstructive pulmonary disease (COPD) through the female hormonal environment, but studies on this topic are limited. This study aimed to assess whether age at menarche, number of children, infertility, miscarriage, stillbirth and age at natural menopause were associated with the risk of COPD. Methods: Women from three cohorts with data on reproductive factors, COPD and covariates were included. Cause specific Cox regression models were adjusted for birth year, race, educational level, body mass index and pack years of smoking, stratified by asthma, and incorporating interaction between birth year and time. Between cohort differences and within cohort correlations were taken into account. Results: Overall, 2 83 070 women were included and 10 737 (3.8%) developed COPD after a median follow-up of 11 (IQR 10-12) years. Analyses revealed a U shaped association between age at menarche and COPD (≤11 vs 13: HR 1.17, 95% CI 1.11 to 1.23; ≥16 vs 13: HR 1.24, 95% CI 1.21 to 1.27). Women with three or more children (3 vs 2: HR 1.14, 95% CI 1.12 to 1.17; ≥4 vs 2: HR 1.34, 95% CI 1.28 to 1.40), multiple miscarriages (2 vs 0: HR 1.28, 95% CI 1.24 to 1.32; ≥3 vs 0: HR 1.36, 95% CI 1.30 to 1.43) or stillbirth (1 vs 0: HR 1.38, 95% CI 1.25 to 1.53; ≥2 vs 0: HR 1.67, 95% CI 1.32 to 2.10) were at a higher risk of COPD. Among postmenopausal women, earlier age at natural menopause was associated with an increased risk of COPD (<40 vs 50-51: HR 1.69, 95% CI 1.63 to 1.75; 40-44 vs 50-51: HR 1.42, 95% CI 1.38 to 1.47). Conclusions: Multiple female reproductive factors, including age at menarche, number of children, miscarriage, stillbirth, and age at natural menopause were associated with the risk of COPD. Competing Interests: Competing interests: GDM reports grants from the Australian National Health and Medical Research Council. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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