title: Parity and Cardiovascular Disease Mortality: a Dose-Response Meta-Analysis of Cohort Studies.
abstract: Parity has been shown to inversely associate with cardiovascular disease (CVD) mortality, but the evidence of epidemiological studies is still controversial. Therefore, we quantitatively assessed the relationship between parity and CVD mortality by summarizing the evidence from prospective studies. We searched MEDLINE (PubMed), EMBASE and ISI Web of Science databases for relevant prospective studies of parity and CVD mortality through the end of March 2015. Fixed- or random-effects models were used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs). Heterogeneity among studies was assessed using the I(2) statistics. All statistical tests were two-sided. Ten prospective studies were included with a total of 994,810 participants and 16,601 CVD events. A borderline significant inverse association was observed while comparing parity with nulliparous, with summarized RR = 0.79 (95% CI: 0.60-1.06; I(2) = 90.9%, P < 0.001). In dose-response analysis, we observed a significant nonlinear association between parity number and CVD mortality. The greatest risk reduction appeared when the parity number reached four. The findings of this meta-analysis suggests that ever parity is inversely related to CVD mortality. Furthermore, there is a statistically significant nonlinear inverse association between parity number and CVD mortality.
authors: Department of Cardiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, Liaoning, China, 116011.|Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China, 200032.
authors: Haichen
authors: H
authors: Lv
authors: Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China, 200032.
authors: Hongyi
authors: H
authors: Wu
authors: Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China, 200032.
authors: Jiasheng
authors: J
authors: Yin
authors: Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China, 200032.
authors: Juying
authors: J
authors: Qian
authors: Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China, 200032.
authors: Junbo
authors: J
authors: Ge
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010298:Parity; D036801:Parturition; D011247:Pregnancy; D012307:Risk Factors; D055815:Young Adult