title: Female reproductive factors and primary open-angle glaucoma in the Nurses' Health Study.
abstract: OBJECTIVE
  The purpose of this study was to explore the relation between age at menarche, parity, and oral contraceptive (OC) use, and primary open-angle glaucoma (POAG).
  
  
  METHODS
  We followed 79 440 women in the Nurses' Health Study prospectively from 1980 to 2006 and identified 813 cases of incident POAG. Eligible participants were ≥40 years old, free of POAG at baseline, had information on reproductive history, and reported receiving eye examinations during follow-up. Relevant exposure data and POAG risk factors were updated using biennial questionnaires. We used proportional hazards models to calculate multivariable rate ratios (MVRRs) of POAG and 95% confidence intervals (CI).
  
  
  RESULTS
  In multivariable analysis, there were no significant linear trends between age at menarche (P for trend=0.65) or reproductive duration defined as time between age at menarche and menopause (P for trend=0.30) and POAG. Although ever using OCs was not associated with POAG risk (MVRR=1.14; 95% CI, 0.98, 1.34), ≥5 years of OC use was associated with a modest 25% increased risk of POAG (MVRR=1.25; 95% CI, 1.02, 1.53; P for linear trend=0.04). Furthermore, among past OC users, a shorter time since stopping OC use was also associated with an increased risk of POAG (P for linear trend=0.02). Parity was not associated with POAG risk.
  
  
  CONCLUSIONS
  The ≥5 years of OC use was associated with a modestly increased risk of POAG. These data add further support for a role of circulating estrogen in the pathogenesis of POAG.
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Brigham and Women's Hospital, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA. Louis_Pasquale@meei.harvard.edu
authors.forename: L R
authors.initials: LR
authors.lastname: Pasquale
authors.forename: J H
authors.initials: JH
authors.lastname: Kang
mesh_terms: D000328:Adult; D000367:Age Factors; D003276:Contraceptives, Oral / Q000008:administration & dosage; D005260:Female; D005902:Glaucoma, Open-Angle / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008572:Menarche; D008593:Menopause / Q000502:physiology; D008597:Menstrual Cycle / Q000502:physiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009726:Nurses; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D017584:Reproductive History; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D003276:Contraceptives, Oral