Socioeconomic disparities in the associations of age at last live birth with stroke and its subtypes among Chinese parous postmenopausal women: A prospective cohort study

IF 3.9

Experimental gerontology Pub Date : 2025-05-29 DOI:10.1016/j.exger.2025.112791

Shiyi Shan , Weidi Sun , Jing Wu, Leying Hou, Zeyu Luo, Jiali Zhou, Jiayao Ying, Peige Song

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Abstract

Background

As a pivotal reproductive factor, age at last live birth (ALLB) plays a critical role in a woman's health trajectory, including the risk of cardiovascular diseases.

Methods

In this prospective cohort study from the China Kadoorie Biobank (CKB), 148,456 parous postmenopausal women were included. ALLB was further classified equally into tertiles (<26 years, 26–29 years, and ≥30 years). Total stroke and its three subtypes (ischemic stroke [IS], intracerebral hemorrhage [ICH], and subarachnoid hemorrhage [SAH]) were identified as outcomes. Cox proportional hazard regression was performed to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for the associations of ALLB with incident stroke and its subtypes. Latent class analysis (LCA) was employed to explore underlying socioeconomic status (SES) classes within women in urban and rural areas, and SES-stratified analysis was conducted. Population attributable fraction (PAF) was estimated to assess the impact of later ALLB on stroke at the population level.

Results

Compared with women with ALLB of <26 years, women with later ALLB (26–29 years and ≥ 30 years) faced a higher risk of stroke, with the highest fully adjusted HRs (aHRs) observed in women whose ALLB was ≥30 years (total stroke: 3.88, 95 % CI 3.71–4.07; IS: 5.33, 95 % CI 5.05–5.63; ICH: 3.79, 95 % CI 3.36–4.29; SAH: 4.93, 95 % CI 3.41–7.12). The strongest associations were found among rural-low-SES participants with total stroke and IS, with aHRs of 5.61 (95 % CI 5.12–6.16) and 7.28 (95 % CI 6.51–8.14) for an ALLB of ≥30 years. The highest PAF of total stroke with ALLB ≥26 years was observed in rural-middle-SES individuals, with value of 59.15 % (95 % CI 56.80–61.48).

Conclusion

Later ALLB was associated with an increased risk of stroke among Chinese parous postmenopausal women, notably in lower socioeconomic rural populations.

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社会经济差异与中国绝经后妇女最后活产年龄与中风及其亚型的关系：一项前瞻性队列研究

背景：作为一个关键的生殖因素，最终活产年龄（ALLB）在女性的健康轨迹中起着至关重要的作用，包括心血管疾病的风险。方法：在这项来自中国嘉道理生物库（CKB）的前瞻性队列研究中，纳入了148,456名绝经后妇女。结果：与患ALLB的妇女相比，结论：晚期ALLB与中国绝经后妇女中风风险增加有关，特别是在社会经济地位较低的农村人群中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊