| Title: | Reproductive factors and the risk of incident peripheral arterial disease hospitalisation or death: A cohort study of UK Biobank participants |
| Journal: | American Journal of Obstetrics and Gynecology |
| Published: | 1 Jul 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40609851/ |
| DOI: | https://doi.org/10.1016/j.ajog.2025.06.062 |
Publication 16356
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Abstract
OBJECTIVE: Associations between reproductive factors and risk of peripheral arterial disease are not well established. This study examined reproductive factors and hormone use in relation to incident peripheral arterial disease risk in women.</p>
STUDY DESIGN: UK Biobank cohort study, excluding participants with prior diagnosis of peripheral arterial disease. Self-reported reproductive factors included were age at menarche, parity-related factors (including live birth, miscarriages, stillbirths, and abortions), menopause-related factors (including reproductive years, age at menopause, hysterectomy, and oophorectomy), and exogenous hormone use (including oral contraceptive pill and hormone replacement therapy use). Participant baseline data were linked with hospital admission data and the national death register to identify the first record of peripheral arterial disease. Poisson regression estimated sex-specific incidence rates of peripheral arterial disease per 10,000 person years and Cox proportional hazard regressions estimated confounder-adjusted hazard ratios linking reproductive factors with incident peripheral arterial disease. The association between number of children and peripheral arterial disease was also examined for men and compared between the sexes.</p>
RESULTS: Over a median follow-up of 13.2 years, 2942/272,557 women and 5432/227,403 men developed peripheral arterial disease. Early and late menarche (age <12 and >14 years) was associated with increased peripheral arterial disease risk (adjusted hazard ratio, 1.43; 95% confidence interval, 1.32, 1.55; P<.001, 1.36 [1.23, 1.49], P<.001, respectively). Reduction in peripheral arterial disease risk was observed for an older age at first birth (adjusted hazard ratio, 0.95 [0.94, 0.96]; P<.001, per year). While, cumulative increased peripheral arterial disease risk was observed per miscarriage (adjusted hazard ratio, 1.06 [1.01, 1.11]; P=.027), per stillbirth (adjusted hazard ratio, 1.18 [1.03, 1.36]; P=.014), and per abortion (adjusted hazard ratio, 1.09 [1.01, 1.18]; P=.028). A longer duration of reproductive years, later natural menopause, and use of oral contraceptives (adjusted hazard ratio, 0.85 [0.78, 0.93]; P<.001) were associated with reduced peripheral arterial disease risk. Hysterectomy or oophorectomy were associated with increased peripheral arterial disease risk (adjusted hazard ratio, 1.24 [1.13, 1.35], P<.001; 1.24 [1.10, 1.39], P<.001, respectively). Associations between the number of children and peripheral arterial disease were U-shaped and similar for both sexes, with a multiple-adjusted hazard ratio of 1.13 ([1.00, 1.25], P=.041) for women and 1.25 ([1.16, 1.34], P<.001) for men, with 4 or more children.</p>
CONCLUSION: Reproductive factors are associated with an increased risk of peripheral arterial disease and should be considered in future risk stratification.</p>
4 Authors
- Anna-Louise Pouncey
- Mark Woodward
- Katie Harris
- Rebecca Kelly
1 Application
| Application ID | Title |
|---|---|
| 74018 | Sex differences in the determinants and outcomes of multimorbidity clusters and their constituent conditions in the UK Biobank Study |
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