TY - JOUR
T1 - Association of infertility with premature mortality among US women
T2 - Prospective cohort study
AU - Wang, Yi Xin
AU - Farland, Leslie V.
AU - Wang, Siwen
AU - Gaskins, Audrey J.
AU - Wang, Liang
AU - Rich-Edwards, Janet W.
AU - Tamimi, Rulla
AU - Missmer, Stacey A.
AU - Chavarro, Jorge E.
N1 - Funding Information:
We would like to thank the participants and staff of the Nurses’ Health Study II (NHS-II) for their valuable contributions as well as the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WY. The authors assume full responsibility for analyzes and interpretation of these data. Our data, including code book and analytic code, can be available upon request with permission from our staff. Further information including the procedures for obtaining and accessing data from the Nurses’ Health Studies II is described at https://www.nurseshealthstudy.org/researchers (email: nhsaccess@channing.harvard.edu).”, The study protocol was approved by the institutional review boards of the Brigham and Women's Hospital and the Harvard TH Chan School of Public Health. The completion of the self-administered questionnaire was considered to imply informed consent. Protocol number: 2009-P-002375. This study was supported by grants R01-HD096033, U01-HL145386, U01-CA176726, R01-HL034594, and R01-HL088521 from the National Institutes of Health. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.
Funding Information:
This study was supported by grants R01-HD096033, U01-HL145386, U01-CA176726, R01-HL034594, and R01-HL088521 from the National Institutes of Health. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.
Publisher Copyright:
© 2021 The Author(s)
PY - 2022/3
Y1 - 2022/3
N2 - Background: Infertility has been associated with common chronic non-communicable diseases. However, the association of infertility with long-term mortality is unclear. Methods: We followed 101,777 women aged 25–42 years at enrollment between 1989 and 2017. Biennial questionnaires updated participants’ infertility status and underlying reasons for infertility throughout their reproductive lifespan. Hazard ratios (HRs) for the associations of infertility with the risk of premature mortality (death before age 70 years) were estimated using Cox proportional hazards models. Findings: During 28 years of follow-up, 2174 women died before age 70 years. Infertility was associated with an HR of 1.26 (95% confidence interval: 1.15 to 1.38) for premature death. This relation was largely driven by deaths from cancer (HR = 1.22, 1.08 to 1.39) and was stronger among women reporting infertility at a younger age (HR = 1.35, 1.19 to 1.52 for age ≤ 25 years; 1.23, 1.10 to 1.38 for age 26–30 years; and 1.10, 0.91 to 1.32 for age > 30 years, compared to no infertility). The premature mortality risk was also higher for women who didn't become pregnant after their first report of infertility (HR = 1.39, 1.25 to 1.54) than among women who reported at least one pregnancy after infertility (HR = 1.12, 1.00 to 1.26). When contributing diagnoses of infertility were evaluated, a greater risk of all-cause mortality was associated with infertility due to ovulatory disorders (HR = 1.28, 1.09 to 1.51) and endometriosis (HR = 1.50, 1.22 to 1.83). Interpretation: Infertility may be associated with a greater risk of premature mortality, particularly cancer mortality. Funding: The National Institutes of Health grants.
AB - Background: Infertility has been associated with common chronic non-communicable diseases. However, the association of infertility with long-term mortality is unclear. Methods: We followed 101,777 women aged 25–42 years at enrollment between 1989 and 2017. Biennial questionnaires updated participants’ infertility status and underlying reasons for infertility throughout their reproductive lifespan. Hazard ratios (HRs) for the associations of infertility with the risk of premature mortality (death before age 70 years) were estimated using Cox proportional hazards models. Findings: During 28 years of follow-up, 2174 women died before age 70 years. Infertility was associated with an HR of 1.26 (95% confidence interval: 1.15 to 1.38) for premature death. This relation was largely driven by deaths from cancer (HR = 1.22, 1.08 to 1.39) and was stronger among women reporting infertility at a younger age (HR = 1.35, 1.19 to 1.52 for age ≤ 25 years; 1.23, 1.10 to 1.38 for age 26–30 years; and 1.10, 0.91 to 1.32 for age > 30 years, compared to no infertility). The premature mortality risk was also higher for women who didn't become pregnant after their first report of infertility (HR = 1.39, 1.25 to 1.54) than among women who reported at least one pregnancy after infertility (HR = 1.12, 1.00 to 1.26). When contributing diagnoses of infertility were evaluated, a greater risk of all-cause mortality was associated with infertility due to ovulatory disorders (HR = 1.28, 1.09 to 1.51) and endometriosis (HR = 1.50, 1.22 to 1.83). Interpretation: Infertility may be associated with a greater risk of premature mortality, particularly cancer mortality. Funding: The National Institutes of Health grants.
KW - Infertility, Premature mortality, Women, Public health
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U2 - 10.1016/j.lana.2021.100122
DO - 10.1016/j.lana.2021.100122
M3 - Article
AN - SCOPUS:85126553184
SN - 2667-193X
VL - 7
JO - The Lancet Regional Health - Americas
JF - The Lancet Regional Health - Americas
M1 - 100122
ER -