Birth spacing and maternal risk of invasive epithelial ovarian cancer in a Swedish nationwide cohort.
OBJECTIVE
Pregnancies reduce the risk of ovarian cancer, and among multiparous women, levels of circulating progesterone might be higher during pregnancies with wider birth spacing. We hypothesized that childbirth with wider birth spacing might reduce maternal risk of invasive epithelial ovarian cancer more than births with narrower spacing.


METHODS
We conducted a case-control study nested in a nationwide cohort of Swedish women from 1961 to 2001. We selected five individually age-matched controls for each case of invasive epithelial ovarian cancer, and analysis for the effect of birth spacing was performed for 5,341 cases and 29,047 controls. We applied unconditional logistic regression analyses adjusting for age, ages at childbirth, educational level, area of residence, and gender of offspring.


RESULTS
Relative risk of invasive epithelial ovarian cancer associated with each one-year increase in average birth spacing is 1.00 (95% CI = 0.98-1.01) among all women and 0.99 (0.98-1.01) among those born before 1935 and less likely to have used oral contraceptives. Further analyses on the biparous and triparous women did not find a consistent association between birth spacing and the risk of ovarian cancer.


CONCLUSIONS
Birth spacing is unlikely to be a major determinant underlying the protective effects of childbirth on ovarian cancer risk.
Division of Biostatistics and Epidemiology, Cancer Center, University of Massachusetts Medical School, Worcester, MA, USA.
Inkyung
I
Baik
Mats
M
Lambe
Qin
Q
Liu
Lucy
L
Chie
Sven
S
Cnattingius
Lorelei A
LA
Mucci
Tomas
T
Riman
Anders
A
Ekbom
Hans-Olov
HO
Adami
Chung-Cheng
CC
Hsieh
D000328:Adult; D001721:Birth Intervals; D002277:Carcinoma / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006728:Hormones / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology*; D010298:Parity; D011247:Pregnancy; D011374:Progesterone / Q000378:metabolism; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data; D017584:Reproductive History; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
D006728:Hormones; D011374:Progesterone