女性生育史与老年期认知功能障碍之间的关系  

Relationship between female reproductive history and cognitive impairment in the elderly

作　　者：张宇 潘佳雯 毛佳 周庆[2] 张立秀[1] ZHANG Yu;PAN Jia-wen;MAO Jia;ZHOU Qing;ZHANG Li-xiu(School of Medicine,Huzhou Normal University,Huzhou,Zhejiang 313000,China;不详)

机构地区：[1]湖州师范学院医学院,浙江湖州313000 [2]湖州市中心医院

出　　处：《现代预防医学》2024年第20期3714-3718,3828,共6页Modern Preventive Medicine

基　　金：国家自然科学基金(72174061)。

摘　　要：目的探索女性生育史与老年期认知功能障碍的关系。方法本研究基于中国老年健康调查数据库2018年的调查数据,利用二元logistic回归,并通过R 4.3.3软件构建限制性立方样条模型分析女性孕育次数、孕育年龄与认知功能障碍之间的剂量-反应关系。结果纳入7508名老年女性,其中764名(10.17%)存在认知功能障碍;调整混杂因素后初次孕龄(OR=1.025,95%CI:1.007~1.044)、末次孕龄(OR=1.071,95%CI:1.056~1.086)、孕育次数(OR=1.085,95%CI:1.044~1.127)均对老年女性认知功能产生影响;限制性立方样条模型结果显示,女性孕育次数与认知功能障碍患病风险之间存在线性剂量-反应关系(P_(总趋势)<0.05,P_(非线性)=0.67),孕育次数≤4时,不会对其认知功能产生不利影响(OR<1,95%CI:0.45~1)。当孕育次数=1时,女性孕龄与认知功能障碍患病风险之间均存在非线性剂量-反应关系(P_(总趋势)<0.05,P_(非线性)<0.05),提示最佳生育年龄在27岁至30岁(OR<1,95%CI:0.89~1);当孕育次数>1时,女性初次孕龄、末次孕龄与认知功能障碍患病风险之间均存在非线性剂量-反应关系(P_(总趋势)<0.05,P_(非线性)<0.05),提示最佳生育年龄在22岁至35岁(OR<1,95%CI:0.99~1)。结论女性生育史与其老年期认知功能存在关联,通过限制孕育次数,鼓励适龄生育可以改善女性老年期认知功能。Objective To explore the relationship between female reproductive history and cognitive dysfunction in old age.Methods Based on the survey data of the Chinese Longitudinal Healthy Longevity Survey database in 2018,binary logistic regression and R4.3.3 software were used to construct a restricted cubic spline model to analyze the dose-response relationship between the number of births,gestational age and cognitive dysfunction in women.Results 7508 elderly women were included,of whom 764(10.17%)had cognitive dysfunction.After adjusting for confounding factors,the first gestational age(OR=1.025,95%CI:1.007-1.044),the last gestational age(OR=1.071,95%CI:1.056-1.086),and the number of pregnancies(OR=1.085,95%CI:1.044-1.127)had an impact on the cognitive function of elderly women.The results of the restricted cubic spline model showed that there was a linear dose-response relationship between the number of pregnancies and the risk of cognitive dysfunction in women(P_(overall)<0.05,P_(non-linearity)=0.67),and the cognitive function was not adversely affected when the number of pregnancies was≤4(OR<1,95%CI:0.45-1).When she had only one child,there was a nonlinear dose-response relationship between the gestational age and the risk of cognitive impairment(P_(overall)<0.05,P_(non-linearity)<0.05),suggesting that the best childbearing age was 27 to 30 years old(OR<1,95%CI:0.89-1).When she had more than one child,there was a nonlinear dose-response relationship between the first and last gestational age and the risk of cognitive impairment(P_(overall)<0.05,P_(non-linearity)<0.05),suggesting that the best childbearing age was 22 to 35 years old(OR<1,95%CI:0.99-1).Conclusion There is a correlation between female reproductive history and cognitive function in old age.Limiting the number of childbearing and encouraging age-appropriate childbearing can improve cognitive function in old age.

关 键 词：老年女性 生育史 认知功能 限制性立方样条 

分 类 号：R173[医药卫生—妇幼卫生保健]