Association of intrauterine and early-life exposures with age at menopause in the Sister Study.
Oocytes are formed in utero; menopause occurs when the oocyte pool is depleted. The authors hypothesized that early-life events could affect the number of a woman's oocytes and determine age at menopause. To test their hypothesis, the authors conducted a secondary analysis of baseline data from 22,165 participants in the Sister Study (2003-2007) who were aged 35-59 years at enrollment. To estimate the association between early-life events and age at natural menopause, the authors used Cox proportional hazards models to estimate hazard ratios with 95% confidence intervals, adjusting for current age, race/ethnicity, education, childhood family income, and smoking history. Earlier menopause was associated with in-utero diethylstilbestrol exposure (hazard ratio (HR) = 1.45, 95% confidence interval (CI): 1.27, 1.65). Suggestive associations included maternal prepregnancy diabetes (HR = 1.33, 95% CI: 0.89, 1.98) and low birth weight (HR = 1.09, 95% CI: 0.99, 1.20). Having a mother aged 35 years or older at birth appeared to be associated with a later age at menopause (HR = 0.95, 95% CI: 0.89, 1.01). Birth order, in-utero smoke exposure, and having been breastfed were not related to age at menopause. In-utero and perinatal events may subsequently influence age at menopause.
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, USA. asteiner@med.unc.edu
Anne Z
AZ
Steiner
Aimee A
AA
D'Aloisio
Lisa A
LA
DeRoo
Dale P
DP
Sandler
Donna D
DD
Baird
D000328:Adult; D001722:Birth Order; D001942:Breast Feeding; D004054:Diethylstilbestrol / Q000009:adverse effects; D004968:Estrogens, Non-Steroidal / Q000009:adverse effects; D005260:Female; D006304:Health Status; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008423:Maternal Age; D018811:Maternal Exposure; D008431:Maternal-Fetal Exchange; D008593:Menopause; D008875:Middle Aged; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D035781:Siblings; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors
D004968:Estrogens, Non-Steroidal; D004054:Diethylstilbestrol