International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
Age at first birth and risk of cardiovascular-kidney-metabolic syndrome in US women aged 40 years and older: A nationally representative cross-sectional study.
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Jing Yehua, Lu Chenyan, Wang Rong, Chen Tianquan
Аннотация
OBJECTIVE: Age at first birth (AFB) is an important reproductive factor influencing long-term metabolic health. This study aimed to examine the associations between AFB and prevalence of cardiovascular-kidney-metabolic (CKM) syndrome among middle-aged and older US women.
METHODS: US women aged ≥ 40 years at the time of the survey were analyzed using 1999-2018 National Health and Nutrition Examination Survey data. AFB was ascertained via self-report from a reproductive health questionnaire. CKM syndrome was defined using the 2023 American Heart Association criteria. Multivariate logistic regression models, restricted cubic spline analysis, and subgroup analysis were used for statistical analyses.
RESULTS: Among 6840 women (mean age 63 years; mean AFB 22 years) included, restricted cubic spline curve showed a U-shaped association between AFB and CKM syndrome prevalence, with the nadir at AFB = 24 years. The odds ratios (95% confidence intervals) per 1-year increase in AFB were 0.878 (0.817-0.944) for participants with AFB < 24 years and 1.019 (0.949-1.095) for those with AFB > 24 years. Compared with the reference group (AFB 24-29 years), women with AFB < 18 years had 86.3% higher odds of CKM syndrome. Subgroup analysis revealed a stronger association between AFB and the odds of CKM syndrome among premenopausal women (p for interaction = 0.023).
CONCLUSION: Early AFB < 24 years is associated with a higher likelihood of CKM syndrome in US women aged ≥ 40 years, especially among premenopausal women. Prospectively designed cohort studies are needed to establish AFB as an important factor for mid- to late-life CKM health.
METHODS: US women aged ≥ 40 years at the time of the survey were analyzed using 1999-2018 National Health and Nutrition Examination Survey data. AFB was ascertained via self-report from a reproductive health questionnaire. CKM syndrome was defined using the 2023 American Heart Association criteria. Multivariate logistic regression models, restricted cubic spline analysis, and subgroup analysis were used for statistical analyses.
RESULTS: Among 6840 women (mean age 63 years; mean AFB 22 years) included, restricted cubic spline curve showed a U-shaped association between AFB and CKM syndrome prevalence, with the nadir at AFB = 24 years. The odds ratios (95% confidence intervals) per 1-year increase in AFB were 0.878 (0.817-0.944) for participants with AFB < 24 years and 1.019 (0.949-1.095) for those with AFB > 24 years. Compared with the reference group (AFB 24-29 years), women with AFB < 18 years had 86.3% higher odds of CKM syndrome. Subgroup analysis revealed a stronger association between AFB and the odds of CKM syndrome among premenopausal women (p for interaction = 0.023).
CONCLUSION: Early AFB < 24 years is associated with a higher likelihood of CKM syndrome in US women aged ≥ 40 years, especially among premenopausal women. Prospectively designed cohort studies are needed to establish AFB as an important factor for mid- to late-life CKM health.