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

Sanne A. E. Peters 1, * Yvonne T. Schouw 2 Angela M. Wood 3 Michael J. Sweeting 3 Karel G. M. Moons 2 Elisabete Weiderpass 4, 5, 6, 7 Larraitz Arriola 8 Vassiliki Benetou 9 Heiner Boeing 1 Fabrice Bonnet 10, 11, 12 Salma T. Butt 13 Françoise Clavel-Chapelon 14, 10, 15 Isabel Drake 13 Diana Gavrila 16 Timothy J. Key 17 Eleni Klinaki Vittorio Krogh 18 Tilman Kühn 19 Camille Lassale 20 Giovanna Masala 21 Giuseppe Matullo 22, 23 Melissa Merritt 20 Elena Molina-Portillo 24 Conchi Moreno-Iribas 25 Therese H. Nost 4 Anja Olsen 26 N. Charlotte Onland-Moret 2 Kim Overvad 27 Salvatore Panico 28 M. Luisa Redondo 29 Anne Tjønneland 26 Antonia Trichopoulou 30 Rosario Tumino 31 Renee Turzanski-Fortner 19 Ioanna Tzoulaki 32 Patrik Wennberg 33 Anna Winkvist 33 Simon G. Thompson 3 Emanuele Di Angelantonio 3 Elio Riboli 19 Nicholas J. Wareham 34 John Danesh 3 Adam S. Butterworth 3
* Auteur correspondant
14 U1018 (Équipe 9) - Mode de vie, génétique et santé : études intégratives et transgénérationnelles
CESP - Centre de recherche en épidémiologie et santé des populations, IGR - Institut Gustave Roussy
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.
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European Journal of Preventive Cardiology, Sage Publications, 2016, 23 (16), pp.1755-1765. 〈10.1177/2047487316658571〉
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Sanne A. E. Peters, Yvonne T. Schouw, Angela M. Wood, Michael J. Sweeting, Karel G. M. Moons, et al.. Parity, breastfeeding and risk of coronary heart disease: A pan-European case-cohort study. European Journal of Preventive Cardiology, Sage Publications, 2016, 23 (16), pp.1755-1765. 〈10.1177/2047487316658571〉. 〈hal-01397737〉

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