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Parity, breastfeeding and risk of coronary heart disease : A pan-European case-cohort study

Peters, Sanne A E; Van Der Schouw, Yvonne T.; Wood, Angela M.; Sweeting, Michael J.; Moons, Karel G M; Weiderpass, Elisabete; Arriola, Larraitz; Benetou, Vassiliki; Boeing, Heiner and Bonnet, Fabrice, et al. (2016) In European Journal of Preventive Cardiology 23(16). p.1755-1765
Abstract

Objective There is uncertainty about the direction and magnitude of the associations between parity, breastfeeding and the risk of coronary heart disease (CHD). We examined the separate and combined associations of parity and breastfeeding practices with the incidence of CHD later in life among women in a large, pan-European cohort study. Methods Data were used from European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD, a case-cohort study nested within the EPIC prospective study of 520,000 participants from 10 countries. Information on reproductive history was available for 14,917 women, including 5138 incident cases of CHD. Using Prentice-weighted Cox regression separately for each country followed by a... (More)

Objective There is uncertainty about the direction and magnitude of the associations between parity, breastfeeding and the risk of coronary heart disease (CHD). We examined the separate and combined associations of parity and breastfeeding practices with the incidence of CHD later in life among women in a large, pan-European cohort study. Methods Data were used from European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD, a case-cohort study nested within the EPIC prospective study of 520,000 participants from 10 countries. Information on reproductive history was available for 14,917 women, including 5138 incident cases of CHD. Using Prentice-weighted Cox regression separately for each country followed by a random-effects meta-analysis, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for CHD, after adjustment for age, study centre and several socioeconomic and biological risk factors. Results Compared with nulliparous women, the adjusted HR was 1.19 (95% CI: 1.01-1.41) among parous women; HRs were higher among women with more children (e.g., adjusted HR: 1.95 (95% CI: 1.19-3.20) for women with five or more children). Compared with women who did not breastfeed, the adjusted HR was 0.71 (95% CI: 0.52-0.98) among women who breastfed. For childbearing women who never breastfed, the adjusted HR was 1.58 (95% CI: 1.09-2.30) compared with nulliparous women, whereas for childbearing women who breastfed, the adjusted HR was 1.19 (95% CI: 0.99-1.43). Conclusion Having more children was associated with a higher risk of CHD later in life, whereas breastfeeding was associated with a lower CHD risk. Women who both had children and breastfed did have a non-significantly higher risk of CHD.

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publication status
published
subject
keywords
breastfeeding, coronary heart disease, Parity, Women
in
European Journal of Preventive Cardiology
volume
23
issue
16
pages
11 pages
publisher
SAGE Publications Inc.
external identifiers
  • scopus:84991442208
  • wos:000385811000007
ISSN
2047-4873
DOI
10.1177/2047487316658571
language
English
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yes
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b2d7b191-e024-415b-acb9-c51c060100e2
date added to LUP
2016-10-28 11:04:39
date last changed
2017-10-01 05:25:02
@article{b2d7b191-e024-415b-acb9-c51c060100e2,
  abstract     = {<p>Objective There is uncertainty about the direction and magnitude of the associations between parity, breastfeeding and the risk of coronary heart disease (CHD). We examined the separate and combined associations of parity and breastfeeding practices with the incidence of CHD later in life among women in a large, pan-European cohort study. Methods Data were used from European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD, a case-cohort study nested within the EPIC prospective study of 520,000 participants from 10 countries. Information on reproductive history was available for 14,917 women, including 5138 incident cases of CHD. Using Prentice-weighted Cox regression separately for each country followed by a random-effects meta-analysis, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for CHD, after adjustment for age, study centre and several socioeconomic and biological risk factors. Results Compared with nulliparous women, the adjusted HR was 1.19 (95% CI: 1.01-1.41) among parous women; HRs were higher among women with more children (e.g., adjusted HR: 1.95 (95% CI: 1.19-3.20) for women with five or more children). Compared with women who did not breastfeed, the adjusted HR was 0.71 (95% CI: 0.52-0.98) among women who breastfed. For childbearing women who never breastfed, the adjusted HR was 1.58 (95% CI: 1.09-2.30) compared with nulliparous women, whereas for childbearing women who breastfed, the adjusted HR was 1.19 (95% CI: 0.99-1.43). Conclusion Having more children was associated with a higher risk of CHD later in life, whereas breastfeeding was associated with a lower CHD risk. Women who both had children and breastfed did have a non-significantly higher risk of CHD.</p>},
  author       = {Peters, Sanne A E and Van Der Schouw, Yvonne T. and Wood, Angela M. and Sweeting, Michael J. and Moons, Karel G M and Weiderpass, Elisabete and Arriola, Larraitz and Benetou, Vassiliki and Boeing, Heiner and Bonnet, Fabrice and Butt, Salma T. and Clavel-Chapelon, Françoise and Drake, Isabel and Gavrila, Diana and Key, Timothy J. and Klinaki, Eleni and Krogh, Vittorio and Kühn, Tilman and Lassale, Camille and Masala, Giovanna and Matullo, Giuseppe and Merritt, Melissa and Molina-Portillo, Elena and Moreno-Iribas, Conchi and Nøst, Therese H. and Olsen, Anja and Onland-Moret, N. Charlotte and Overvad, Kim and Panico, Salvatore and Redondo, M. Luisa and Tjønneland, Anne and Trichopoulou, Antonia and Tumino, Rosario and Turzanski-Fortner, Renée and Tzoulaki, Ioanna and Wennberg, Patrik and Winkvist, Anna and Thompson, Simon G. and Di Angelantonio, Emanuele and Riboli, Elio and Wareham, Nicholas J. and Danesh, John and Butterworth, Adam S.},
  issn         = {2047-4873},
  keyword      = {breastfeeding,coronary heart disease,Parity,Women},
  language     = {eng},
  month        = {11},
  number       = {16},
  pages        = {1755--1765},
  publisher    = {SAGE Publications Inc.},
  series       = {European Journal of Preventive Cardiology},
  title        = {Parity, breastfeeding and risk of coronary heart disease : A pan-European case-cohort study},
  url          = {http://dx.doi.org/10.1177/2047487316658571},
  volume       = {23},
  year         = {2016},
}