Age at First Birth, Parity and History of Hysterectomy Are Associated to Frailty Status: Cross-Sectional Analysis from the International Mobility in Aging Study -Imias

Frailty at older ages is an adverse health condition that is more prevalent in women than men and the excess prevalence in women cannot be adequately explained by common risk factors. Reproductive history events may be among contributing factors. This study aims to examine associations between age at first childbirth, lifetime parity, and history of hysterectomy with frailty status in community dwelling older women. This is a cross-sectional study of 1047 women participating in the International Mobility in Aging Study at baseline (2012, aged between 65 and 74 years old). Fried's phenotype of frailty was used to identify frail, pre-frail and non-frail groups. Measured reproductive history variables include age at first birth (before 20 years old; 20 years old or older), lifetime parity (0; 1-2 children; 3-4 children; 5 children or more) and hysterectomy (yes/no). We constructed multinomial regression models adjusted for possible confounders to examine the relationships of interest; non frail women were the reference category. Early maternal age (before 20 years-old) was associated with increased risk of frailty (OR 2.15, 95%CI: 1.24-3.72). Compared to women who delivered five or more children, those who had 1-2 children showed significantly lower odds of pre-frail status (OR 0.54, 95%CI 0.36-0.82) and frailty (OR 0.43 95%CI 0.22-0.86). Hysterectomy was independently associated with frailty (OR 1.74 95%CI 1.04-2.89) Age at first birth, parity and hysterectomy are associated to a greater likelihood of frailty in later life. This study reinforces the importance of considering the reproductive characteristics of women as indicators of health status.