Socioeconomic variations in the proportions of stroke attributable to reproductive profiles among postmenopausal women in China
Abstract Background This prospective study aimed to examine the individual and combined population attributable fractions (PAFs) of stroke and its subtypes associated with reproductive factors among Chinese postmenopausal women, highlighting variations across socioeconomic status (SES) stratas. Meth...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-03-01
|
| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-025-03976-5 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850039921707843584 |
|---|---|
| author | Weidi Sun Jing Wu Shiyi Shan Leying Hou Zeyu Luo Jiali Zhou Peige Song |
| author_facet | Weidi Sun Jing Wu Shiyi Shan Leying Hou Zeyu Luo Jiali Zhou Peige Song |
| author_sort | Weidi Sun |
| collection | DOAJ |
| description | Abstract Background This prospective study aimed to examine the individual and combined population attributable fractions (PAFs) of stroke and its subtypes associated with reproductive factors among Chinese postmenopausal women, highlighting variations across socioeconomic status (SES) stratas. Methods Data were from 138,873 Chinese postmenopausal women enrolled in the China Kadoorie Biobank. Reproductive factors evaluated in this study included early age at menarche, early age at menopause, advanced age at first live birth, high parity, history of stillbirth, history of miscarriage or termination, and non-lactation. PAFs were calculated using hazard ratios, estimated using Cox proportional hazard regression, and prevalence of the seven reproductive factors. PAF for each reproductive risk factor and combined PAFs for all factors were estimated in total population and across SES classes. Results Of the 138,873 included participants, 17,042 developed strokes during a median follow-up period of 8.9 years. Across SES classes, the greatest attributable fractions of total stroke cases were observed for high parity among low-SES women (PAF 17.2%, 95% confidence interval [CI] 13.7%, 20.6%), history of miscarriage or termination among medium-SES women (PAF 11.4%, 95% CI 8.2%, 14.5%), and no history of lactation among high-SES women (PAF 3.1%, 95% CI 1.7%, 4.9%). A multiplicatively estimated 20.5% (95% CI 20.4%, 20.5%) and 3.1% (95% CI 1.7%, 4.9%) of stroke cases were attributable to the seven reproductive risk factors in low-SES and high-SES women, respectively. Conclusions A large fraction of stroke cases among Chinese postmenopausal women were associated with reproductive factors. Targeted cardiovascular prevention strategies are warranted among women with different SES to mitigate risks associated with different reproductive profiles. |
| format | Article |
| id | doaj-art-9b71905598ed478f9c20802dfefbd53c |
| institution | DOAJ |
| issn | 1741-7015 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj-art-9b71905598ed478f9c20802dfefbd53c2025-08-20T02:56:12ZengBMCBMC Medicine1741-70152025-03-0123111410.1186/s12916-025-03976-5Socioeconomic variations in the proportions of stroke attributable to reproductive profiles among postmenopausal women in ChinaWeidi Sun0Jing Wu1Shiyi Shan2Leying Hou3Zeyu Luo4Jiali Zhou5Peige Song6Center for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health, Zhejiang University School of MedicineCenter for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health, Zhejiang University School of MedicineCenter for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health, Zhejiang University School of MedicineCenter for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health, Zhejiang University School of MedicineCenter for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health, Zhejiang University School of MedicineCenter for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health, Zhejiang University School of MedicineCenter for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health, Zhejiang University School of MedicineAbstract Background This prospective study aimed to examine the individual and combined population attributable fractions (PAFs) of stroke and its subtypes associated with reproductive factors among Chinese postmenopausal women, highlighting variations across socioeconomic status (SES) stratas. Methods Data were from 138,873 Chinese postmenopausal women enrolled in the China Kadoorie Biobank. Reproductive factors evaluated in this study included early age at menarche, early age at menopause, advanced age at first live birth, high parity, history of stillbirth, history of miscarriage or termination, and non-lactation. PAFs were calculated using hazard ratios, estimated using Cox proportional hazard regression, and prevalence of the seven reproductive factors. PAF for each reproductive risk factor and combined PAFs for all factors were estimated in total population and across SES classes. Results Of the 138,873 included participants, 17,042 developed strokes during a median follow-up period of 8.9 years. Across SES classes, the greatest attributable fractions of total stroke cases were observed for high parity among low-SES women (PAF 17.2%, 95% confidence interval [CI] 13.7%, 20.6%), history of miscarriage or termination among medium-SES women (PAF 11.4%, 95% CI 8.2%, 14.5%), and no history of lactation among high-SES women (PAF 3.1%, 95% CI 1.7%, 4.9%). A multiplicatively estimated 20.5% (95% CI 20.4%, 20.5%) and 3.1% (95% CI 1.7%, 4.9%) of stroke cases were attributable to the seven reproductive risk factors in low-SES and high-SES women, respectively. Conclusions A large fraction of stroke cases among Chinese postmenopausal women were associated with reproductive factors. Targeted cardiovascular prevention strategies are warranted among women with different SES to mitigate risks associated with different reproductive profiles.https://doi.org/10.1186/s12916-025-03976-5StrokeSocioeconomic statusPopulation attributable fractionPostmenopausal womenReproductive factors |
| spellingShingle | Weidi Sun Jing Wu Shiyi Shan Leying Hou Zeyu Luo Jiali Zhou Peige Song Socioeconomic variations in the proportions of stroke attributable to reproductive profiles among postmenopausal women in China BMC Medicine Stroke Socioeconomic status Population attributable fraction Postmenopausal women Reproductive factors |
| title | Socioeconomic variations in the proportions of stroke attributable to reproductive profiles among postmenopausal women in China |
| title_full | Socioeconomic variations in the proportions of stroke attributable to reproductive profiles among postmenopausal women in China |
| title_fullStr | Socioeconomic variations in the proportions of stroke attributable to reproductive profiles among postmenopausal women in China |
| title_full_unstemmed | Socioeconomic variations in the proportions of stroke attributable to reproductive profiles among postmenopausal women in China |
| title_short | Socioeconomic variations in the proportions of stroke attributable to reproductive profiles among postmenopausal women in China |
| title_sort | socioeconomic variations in the proportions of stroke attributable to reproductive profiles among postmenopausal women in china |
| topic | Stroke Socioeconomic status Population attributable fraction Postmenopausal women Reproductive factors |
| url | https://doi.org/10.1186/s12916-025-03976-5 |
| work_keys_str_mv | AT weidisun socioeconomicvariationsintheproportionsofstrokeattributabletoreproductiveprofilesamongpostmenopausalwomeninchina AT jingwu socioeconomicvariationsintheproportionsofstrokeattributabletoreproductiveprofilesamongpostmenopausalwomeninchina AT shiyishan socioeconomicvariationsintheproportionsofstrokeattributabletoreproductiveprofilesamongpostmenopausalwomeninchina AT leyinghou socioeconomicvariationsintheproportionsofstrokeattributabletoreproductiveprofilesamongpostmenopausalwomeninchina AT zeyuluo socioeconomicvariationsintheproportionsofstrokeattributabletoreproductiveprofilesamongpostmenopausalwomeninchina AT jializhou socioeconomicvariationsintheproportionsofstrokeattributabletoreproductiveprofilesamongpostmenopausalwomeninchina AT peigesong socioeconomicvariationsintheproportionsofstrokeattributabletoreproductiveprofilesamongpostmenopausalwomeninchina |