Parity, breastfeeding and risk of coronary heart disease: A pan-European case–cohort study

Title: Parity, breastfeeding and risk of coronary heart disease: A pan-European case–cohort study
Authors: Peters, SA
Van der Schouw, YT
Wood, AM
Sweeting, MJ
Moons, KG
Weiderpass, E
Arriola, L
Benetou, V
Boeing, H
Bonnet, F
Butt, ST
Clavel-Chapelon, F
Drake, I
Gavrila, D
Key, TJ
Klinaki, E
Krogh, V
Kühn, T
Lassale, C
Masala, G
Matullo, G
Merritt, M
Molina-Portillo, E
Moreno-Iribas, C
Nøst, TH
Olsen, A
Onland-Moret, NC
Overvad, K
Panico, S
Redondo, ML
Tjønneland, A
Trichopoulou, A
Tumino, R
Turzanski-Fortner, R
Tzoulaki, I
Wennberg, P
Winkvist, A
Thompson, SG
Di Angelantonio, E
Riboli, E
Wareham, NJ
Danesh, J
Butterworth, AS
Item Type: Journal Article
Abstract: OBJECTIVE: There is uncertainty about the direction and magnitude of the associations between parity, breastfeeding and the risk of coronary heart disease (CHD). We examined the separate and combined associations of parity and breastfeeding practices with the incidence of CHD later in life among women in a large, pan-European cohort study. METHODS: Data were used from European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD, a case-cohort study nested within the EPIC prospective study of 520,000 participants from 10 countries. Information on reproductive history was available for 14,917 women, including 5138 incident cases of CHD. Using Prentice-weighted Cox regression separately for each country followed by a random-effects meta-analysis, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for CHD, after adjustment for age, study centre and several socioeconomic and biological risk factors. RESULTS: Compared with nulliparous women, the adjusted HR was 1.19 (95% CI: 1.01-1.41) among parous women; HRs were higher among women with more children (e.g., adjusted HR: 1.95 (95% CI: 1.19-3.20) for women with five or more children). Compared with women who did not breastfeed, the adjusted HR was 0.71 (95% CI: 0.52-0.98) among women who breastfed. For childbearing women who never breastfed, the adjusted HR was 1.58 (95% CI: 1.09-2.30) compared with nulliparous women, whereas for childbearing women who breastfed, the adjusted HR was 1.19 (95% CI: 0.99-1.43). CONCLUSION: Having more children was associated with a higher risk of CHD later in life, whereas breastfeeding was associated with a lower CHD risk. Women who both had children and breastfed did have a non-significantly higher risk of CHD.
Issue Date: 4-Jul-2016
Date of Acceptance: 15-Jun-2016
ISSN: 2047-4881
Publisher: SAGE Publications
Start Page: 1755
End Page: 1765
Journal / Book Title: European Journal of Preventive Cardiology
Volume: 23
Issue: 16
Copyright Statement: © 2016 European Society of Cardiology
Sponsor/Funder: Commission of the European Communities
Funder's Grant Number: 279233
Keywords: Parity
coronary heart disease
Publication Status: Published
Open Access location:
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care

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