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Parity, breastfeeding and risk of coronary heart disease: A pan-European case-cohort study

Sanne A. E. Peters 1, * Yvonne T. Schouw 2 Angela M. Wood 3 Michael J. Sweeting 3 Karel G. M. Moons 2 Elisabete Weiderpass 4, 5, 6, 7 Larraitz Arriola 8 Vassiliki Benetou 9, 10 Heiner Boeing 1 Fabrice Bonnet 11, 12, 13 Salma T. Butt 14 Françoise Clavel-Chapelon 15, 11, 16 Isabel Drake 14 Diana Gavrila 17 Timothy J. Key 18 Eleni Klinaki 10 Vittorio Krogh 19 Tilman Kühn 20 Camille Lassale 21 Giovanna Masala 22 Giuseppe Matullo 23, 24 Melissa Merritt 21 Elena Molina-Portillo 25 Conchi Moreno-Iribas 26 Therese H. Nost 4 Anja Olsen 27 N. Charlotte Onland-Moret 2 Kim Overvad 28 Salvatore Panico 29 M. Luisa Redondo 30 Anne Tjønneland 27 Antonia Trichopoulou 10, 31 Rosario Tumino 32 Renee Turzanski-Fortner 20 Ioanna Tzoulaki 33 Patrik Wennberg 34 Anna Winkvist 34 Simon G. Thompson 3 Emanuele Di Angelantonio 3 Elio Riboli 20 Nicholas J. Wareham 35 John Danesh 3 Adam S. Butterworth 3
* Corresponding author
7 Genetic Epidemiology Group [Helsinki]
Folkhälsan Research Center
15 U1018 (Équipe 9) - Mode de vie, génétique et santé : études intégratives et transgénérationnelles
CESP - Centre de recherche en épidémiologie et santé des populations, IGR - Institut Gustave Roussy
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.
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Sanne A. E. Peters, Yvonne T. Schouw, Angela M. Wood, Michael J. Sweeting, Karel G. M. Moons, et al.. Parity, breastfeeding and risk of coronary heart disease: A pan-European case-cohort study. European Journal of Preventive Cardiology, Sage Publications, 2016, 23 (16), pp.1755-1765. ⟨10.1177/2047487316658571⟩. ⟨hal-01397737⟩



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