title: Reproductive history and post-reproductive mortality: A sibling comparison analysis using Swedish register data.
abstract: A growing body of evidence suggests that reproductive history influences post-reproductive mortality. A potential explanation for this association is confounding by socioeconomic status in the family of origin, as socioeconomic status is related to both fertility behaviours and to long-term health. We examine the relationship between age at first birth, completed parity, and post-reproductive mortality and address the potential confounding role of family of origin. We use Swedish population register data for men and women born 1932-1960, and examine both all-cause and cause-specific mortality. The contributions of our study are the use of a sibling comparison design that minimizes residual confounding from shared family background characteristics and assessment of cause-specific mortality that can shed light on the mechanisms linking reproductive history to mortality. Our results were entirely consistent with previous research on this topic, with teenage first time parents having higher mortality, and the relationship between parity and mortality following a U-shaped pattern where childless men and women and those with five or more children had the highest mortality. These results indicate that selection into specific fertility behaviours based upon socioeconomic status and experiences within the family of origin does not explain the relationship between reproductive history and post-reproductive mortality. Additional analyses where we adjust for other lifecourse factors such as educational attainment, attained socioeconomic status, and post-reproductive marital history do not change the results. Our results add an important new level of robustness to the findings on reproductive history and mortality by showing that the association is robust to confounding by factors shared by siblings. However it is still uncertain whether reproductive history causally influences health, or whether other confounding factors such as childhood health or risk-taking propensity could explain the association.
authors.affiliation: Department of Social Policy, London School of Economics and Political Science, Old Building, Houghton St., London, WC2A 2AE, UK; Department of Sociology, Stockholm University, 106 91, Stockholm, Sweden; Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057, Rostock, Germany. Electronic address: k.j.barclay@lse.ac.uk.
authors.forename: Kieron
authors.initials: K
authors.lastname: Barclay
authors.affiliation: Department of Social Policy, London School of Economics and Political Science, Old Building, Houghton St., London, WC2A 2AE, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Keenan
authors.affiliation: Department of Social Policy, London School of Economics and Political Science, Old Building, Houghton St., London, WC2A 2AE, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Grundy
authors.affiliation: Department of Sociology, Stockholm University, 106 91, Stockholm, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Kolk
authors.affiliation: Department of Social Policy, London School of Economics and Political Science, Old Building, Houghton St., London, WC2A 2AE, UK; Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057, Rostock, Germany; Population Research Unit, Department of Social Research, University of Helsinki, P.O. Box 18, 00014, Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Myrskylä
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D010298:Parity; D011247:Pregnancy; D012042:Registries; D017584:Reproductive History; D035781:Siblings; D013548:Sweden / Q000453:epidemiology
keywords: Age at first birth; Mortality; Parity; Reproductive history; Sibling fixed effects; Sweden