title: Cause-specific mortality of grand multiparous women in Finland.
abstract: Knowledge is limited on mortality of grand multiparous women (> or =5 deliveries), whose hormonal, metabolic, and social conditions differ from the average. The authors studied overall and cause-specific mortality in 1974-2001 among 87,922 grand multiparous women including 3,678 grand grand multiparous women (> or =10 deliveries) in Finland. Standardized mortality ratios were defined as ratios of observed to expected numbers of deaths, both derived from national cause-of-death files. During follow-up, 18,870 grand multiparous women and 625 grand grand multiparous women died (standardized mortality ratios (SMRs) = 0.95 and 1.01, respectively). Decreased mortality among grand multiparous women was found for cancers of the breast (SMR = 0.64, 95% confidence interval (CI): 0.59, 0.69), corpus uteri (SMR = 0.68, 95% CI: 0.56, 0.80), ovary (SMR = 0.68, 95% CI: 0.60, 0.75), bladder (SMR = 0.59, 95% CI: 0.41, 0.82), and respiratory tract (SMR = 0.80, 95% CI: 0.72, 0.88). The only malignant tumor associated with elevated mortality was kidney cancer (SMR = 1.38, 95% CI: 1.21, 1.56). The standardized mortality ratio was also low for dementia (SMR = 0.78, 95% CI: 0.72, 0.84), respiratory diseases (SMR = 0.80, 95% CI: 0.75, 0.85), and accidents and violent causes (SMR = 0.79, 95% CI: 0.73, 0.84). Mortality from diabetes mellitus (SMR = 1.42, 95% CI: 1.29, 1.55) and ischemic heart disease (SMR = 1.10, 95% CI: 1.08, 1.13) was increased. According to this study, overall mortality among grand multiparous women is not elevated. Low mortality from cancers is offset by higher mortality from cardiovascular conditions and diabetes mellitus.
authors.affiliation: Department of Obstetrics and Gynecology, Oulu University Hospital, University of Oulu, PL 24, FIN-90029 OYS, Oulu, Finland. marianne.hinkula@oulu.fi
authors.forename: Marianne
authors.initials: M
authors.lastname: Hinkula
authors.forename: Antti
authors.initials: A
authors.lastname: Kauppila
authors.forename: Simo
authors.initials: S
authors.lastname: Näyhä
authors.forename: Eero
authors.initials: E
authors.lastname: Pukkala
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death / Q000639:trends*; D015331:Cohort Studies; D003141:Communicable Diseases / Q000401:mortality; D003920:Diabetes Mellitus / Q000401:mortality; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008428:Maternal Mortality / Q000639:trends; D008659:Metabolic Diseases / Q000401:mortality; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D010298:Parity; D011247:Pregnancy; D012120:Respiration Disorders / Q000401:mortality