1. Parity, breastfeeding and risk of coronary heart disease:A pan-European case-cohort study
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Kim Overvad, Eleni Klinaki, Elisabete Weiderpass, Emanuele Di Angelantonio, Giuseppe Matullo, Giovanna Masala, Anna Winkvist, Simon G. Thompson, M. Luisa Redondo, Françoise Clavel-Chapelon, Isabel Drake, Elena Molina-Portillo, N. Charlotte Onland-Moret, Therese Haugdahl Nøst, Adam S. Butterworth, Salma Butt, Diana Gavrila, Conchi Moreno-Iribas, Vassiliki Benetou, Antonia Trichopoulou, Tilman Kühn, Anja Olsen, Melissa A. Merritt, Ioanna Tzoulaki, Anne Tjønneland, Angela M. Wood, Larraitz Arriola, Renée Turzanski-Fortner, Fabrice Bonnet, Elio Riboli, Rosario Tumino, Karel G.M. Moons, Sanne A.E. Peters, Patrik Wennberg, Heiner Boeing, Timothy J. Key, Yvonne T. van der Schouw, Camille Lassale, Nicholas J. Wareham, Michael J. Sweeting, Salvatore Panico, Vittorio Krogh, John Danesh, Department of Epidemiology, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, University Medical Center [Utrecht], Department of Public Health & Primary Care, University of Cambridge [UK] (CAM), Department of Community Medicine, The Arctic University of Norway [Tromsø, Norway] (UiT), Department of Research, Cancer Registry of Norway, Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet [Stockholm], Genetic Epidemiology Group [Helsinki], Folkhälsan Research Center, Faculty of Medecine [Helsinki], Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Faculty of Medecine [Helsinki], Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Instituto de Investigación Sanitaria Biodonostia - San Sebastián, WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Hellenic Health Foundation, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Foie, métabolismes et cancer, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Department of Clinical Sciences, Lund University [Lund], Mode de vie, génétique et santé : études intégratives et transgénérationnelles (U1018 (Équipe 9)), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR), Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIBER de Epidemiología y Salud Pública (CIBERESP), Cancer Epidemiology Unit, University of Oxford-Cancer Epidemiology Unit, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori - National Cancer Institute [Milan], German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Biomarkers Research, Imperial College School of Public Health, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Department of Genetics, Biology and Biochemistry, Università degli studi di Torino = University of Turin (UNITO), Institute for Scientific Interchange Foundation, Universidad de Granada = University of Granada (UGR), Public Health Institute of Navarra, Pamplona, Spain, and CIBER Epidemiología y Salud Pública (CIBERESP), Danish Cancer Society Research Center, Department of Clinical Epidemiology, Aarhus University Hospital, Dipartimento di Medicina Clinica e Chirurgia, University of Naples Federico II = Università degli studi di Napoli Federico II, Public Health Directorate Asturias, Bureau of Epidemiologic Research, Academy of Athens, Cancer Registry and Histopathology Unit, Department of Oncology-Civile - M.P.Arezzo Hospital, Imperial College London, Umeå University, Medical Research Council Epidemiology Unit, European Union [HEALTH-F2-2012-279233], European Research Council [268834], Swedish Scientific Council, Regional Government of Skane and Vasterbotten (Sweden), Compagnia di San Paolo, Human Genetics Foundation-Torino (HuGeF), UK Medical Research Council [G0800270, MR/L003120/1, MR/M012190/1], British Heart Foundation [SP/09/002, RG/08/014, RG13/13/30194], UK National Institute of Health Research, Regional Government of Asturias, Cancer Research UK [570/A16491], Sicilian Government, AIRE ONLUS Ragusa, AVIS Ragusa, Swedish Cancer Society, The Arctic University of Norway, University of Helsinki-University of Helsinki-Faculty of Medecine [Helsinki], University of Helsinki-University of Helsinki, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut Gustave Roussy (IGR), University of Oxford [Oxford]-Cancer Epidemiology Unit, University of Turin, Universidad de Granada (UGR), University of Naples Federico II, Wood, Angela [0000-0002-7937-304X], Sweeting, Michael [0000-0003-0980-8965], Thompson, Simon [0000-0002-5274-7814], Di Angelantonio, Emanuele [0000-0001-8776-6719], Wareham, Nicholas [0000-0003-1422-2993], Danesh, John [0000-0003-1158-6791], Butterworth, Adam [0000-0002-6915-9015], Apollo - University of Cambridge Repository, Peters, Sanne Ae, van der Schouw, Yvonne T, Wood, Angela M, Sweeting, Michael J, Moons, Karel Gm, Weiderpass, Elisabete, Arriola, Larraitz, Benetou, Vassiliki, Boeing, Heiner, Bonnet, Fabrice, Butt, Salma T, Clavel Chapelon, Françoise, Drake, Isabel, Gavrila, Diana, Key, Timothy J, Klinaki, Eleni, Krogh, Vittorio, Kühn, Tilman, Lassale, Camille, Masala, Giovanna, Matullo, Giuseppe, Merritt, Melissa, Molina Portillo, Elena, Moreno Iribas, Conchi, Nøst, Therese H, Olsen, Anja, Onland Moret, N. Charlotte, Overvad, Kim, Panico, Salvatore, Redondo, M. Luisa, Tjønneland, Anne, Trichopoulou, Antonia, Tumino, Rosario, Turzanski Fortner, Renée, Tzoulaki, Ioanna, Wennberg, Patrik, Winkvist, Anna, Thompson, Simon G, Di Angelantonio, Emanuele, Riboli, Elio, Wareham, Nicholas J, Danesh, John, Butterworth, Adam S., Commission of the European Communities, and Jonchère, Laurent
- Subjects
Pediatrics ,breastfeeding ,coronary heart disease ,Parity ,Women ,Epidemiology ,Cardiology and Cardiovascular Medicine ,Breastfeeding ,Coronary Disease ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Pregnancy ,Risk Factors ,Medicine ,030212 general & internal medicine ,Prospective Studies ,Age of Onset ,Prospective cohort study ,number ,Incidence ,Hazard ratio ,health ,Middle Aged ,3. Good health ,European Prospective Investigation into Cancer and Nutrition ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Europe ,Breast Feeding ,Population Surveillance ,Female ,pregnancy ,women ,Cohort study ,Adult ,medicine.medical_specialty ,life-style ,lactation ,Risk Assessment ,Article ,03 medical and health sciences ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Journal Article ,Humans ,cancer ,maternal cardiovascular-disease ,Proportional hazards model ,business.industry ,duration ,mortality ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Breast feeding ,Demography ,Follow-Up Studies ,Forecasting - 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.
- Published
- 2016