Associations between parity, pregnancy loss, and breastfeeding duration and risk of maternal type 2 diabetes: An observational cohort study

Abstract

Background Parity, pregnancy loss, and breastfeeding duration were found to be associated with diabetes. However, the results are inconsistent. Also, no epidemiological studies have examined the association of these reproductive factors with diabetes in the same large population. We aim to investigate the associations between parity, pregnancy loss, breastfeeding duration, and the risk of maternal diabetes in middle‐aged and elderly Chinese females. Methods We included 131 174 females aged ≥40 years from the REACTION study (Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal Study). Multivariable linear regression and logistic regression were used to assess the association between parity, pregnancy loss, and breastfeeding duration and type 2 diabetes. Results The number of parities and breastfeeding duration were positively related to fasting plasma glucose, 2‐hour postload glucose, glycosylated hemoglobin, and homeostatic model assessment of insulin resistance. Compared with those with one birth, nulliparous women or women with 2 or ≥3 births had a significantly increased risk of diabetes. The odds ratios (OR) and 95% confidence intervals (CI) were 1.27 (1.10‐1.48), 1.17 (1.12‐1.22), and 1.28 (1.21‐1.35), respectively. Compared with women without pregnancy loss, those who underwent 2 (OR 1.09; 95% CI, 1.04‐1.14) or ≥3 pregnancy losses (OR 1.11; 95% CI, 1.04‐1.18) had an increased risk of diabetes. Moreover, women with a breastfeeding duration ≥0 to 6 months (OR 0.82; 95% CI, 0.75‐0.90) and ≥6 to 12 months (OR 0.94; 95% CI, 0.89‐0.99) had a significantly lower risk of diabetes. Conclusions Nulliparous women or women with multiparity or more than one pregnancy loss have an increased risk of diabetes in later life, while women who breastfeed more than 0 to 12 months have a lower risk of diabetes.

Life-course fertility and multimorbidity among middle-aged and elderly women in China: Evidence from China health and retirement longitudinal study

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“…We found that on a variety of neuroplastic and inflammatory markers, parity has a significant impact long after parturition, including some effects that lasted into middle-age. Given that parity is associated with different disease risk for stroke, diabetes, and Alzheimer’s disease (Huo et al, 2021; Lee et al, 2022; Parikh et al, 2010), it is important to understand how the brain may change with parity and age. In our study we found that parity increased PSD-95 and microglia levels in the hippocampus.…”

Environmental contaminants and the disproportionate prevalence of type-2 diabetes mellitus among Indigenous Cree women in James Bay Quebec, Canada

“…Furthermore, data from the large population-based cohort, the Risk Evaluation of Cancers in Chinese Diabetic Individuals (REACTION) study examined cross-sectionally the association between parity and risk of maternal diabetes in females (≥ 40 years of age). Huo et al 50 reported a higher odds of diabetes among multiparous and nulliparious women when compared to primiparous women.…”