Format

Send to

Choose Destination
Eur J Prev Cardiol. 2016 Nov;23(16):1755-1765. Epub 2016 Jul 4.

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

Author information

1
The George Institute for Global Health, University of Oxford, Oxford, UK Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands sanne.peters@georgeinstitute.ox.ac.uk.
2
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
3
Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK The National Institute for Health Research Blood and Transplant Unit (NIHR BTRU) in Donor Health and Genomics at the University of Cambridge, UK.
4
Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK.
5
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
6
Public Health Division of Gipuzkoa, Instituto Bio-Donostia, Basque Government, CIBERESP, Spain.
7
WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece Hellenic Health Foundation, Athens, Greece.
8
Department of Epidemiology, German Institute of Human Nutrition (DIfE), Potsdam-Rehbrücke, Germany.
9
Centre Hospitalier Universitaire Rennes, University of Rennes, Villejuif, France.
10
Department of Surgery, Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
11
INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones, and Women's Health Team, Institut Gustave Roussy, Villejuif, France.
12
Department of Clinical Science, Lund University, Malmö, Sweden.
13
Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
14
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK.
15
Hellenic Health Foundation, Athens, Greece.
16
Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
17
German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany.
18
Department of Epidemiology and Biostatistics, Imperial College London, London, UK.
19
Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy.
20
Human Genetics Foundation, Turin, Italy Department of Medical Sciences, University of Turin, Italy.
21
CIBER Epidemiología y Salud Pública (CIBERESP), Spain Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
22
Public Health Institute of Navarra, Pamplona, Spain Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Madrid, Spain.
23
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
24
Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
25
Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
26
Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
27
Public Health Directorate, Asturias, Spain.
28
Cancer Registry and Histopathology Unit, Civic - M.P. Arezzo Hospital, ASP Ragusa, Italy.
29
Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
30
Nutritional Research, Umeå University, Umeå, Sweden Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
31
Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK.
32
Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK The National Institute for Health Research Blood and Transplant Unit (NIHR BTRU) in Donor Health and Genomics at the University of Cambridge, UK Wellcome Trust Sanger Institute, Genome Campus, Hinxton, UK

Erratum in

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.

KEYWORDS:

Parity; Women; breastfeeding; coronary heart disease

PMID:
27378766
PMCID:
PMC6217919
DOI:
10.1177/2047487316658571
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center