Parity, breastfeeding and risk of coronary heart disease: A pan-European case-cohort study - Université de Rennes Access content directly
Journal Articles European Journal of Preventive Cardiology Year : 2016

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

1 Department of Epidemiology
2 University Medical Center [Utrecht]
3 Department of Public Health & Primary Care
4 Department of Community Medicine
5 Department of Research
6 MEB - Department of Medical Epidemiology and Biostatistics
7 Genetic Epidemiology Group [Helsinki]
8 Instituto de Investigación Sanitaria Biodonostia - San Sebastián
9 WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene
10 Hellenic Health Foundation
11 CESP - Centre de recherche en épidémiologie et santé des populations
12 CHU Pontchaillou [Rennes]
13 Foie, métabolismes et cancer
14 Department of Clinical Sciences
15 U1018 (Équipe 9) - Mode de vie, génétique et santé : études intégratives et transgénérationnelles
16 E3N - Nutrition, hormones et cancer: épidémiologie et prévention
17 CIBER de Epidemiología y Salud Pública (CIBERESP)
18 Cancer Epidemiology Unit
19 Nutritional Epidemiology Unit
20 DKFZ - German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg]
21 Biomarkers Research
22 Molecular and Nutritional Epidemiology Unit
23 Department of Genetics, Biology and Biochemistry
24 Institute for Scientific Interchange Foundation
25 UGR - Universidad de Granada = University of Granada
26 Public Health Institute of Navarra, Pamplona, Spain, and CIBER Epidemiología y Salud Pública (CIBERESP)
27 Danish Cancer Society Research Center
28 Department of Clinical Epidemiology
29 Dipartimento di Medicina Clinica e Chirurgia
30 Public Health Directorate Asturias
31 Bureau of Epidemiologic Research
32 Cancer Registry and Histopathology Unit
33 Imperial College London
34 Umeå University
35 Medical Research Council Epidemiology Unit
Isabel Drake
  • Function : Author
  • PersonId : 937850
Timothy J. Key
  • Function : Author
  • PersonId : 925891
Vittorio Krogh
  • Function : Author
  • PersonId : 937840
Melissa Merritt
  • Function : Author
  • PersonId : 950022
Anja Olsen
Anne Tjønneland
Rosario Tumino
Ioanna Tzoulaki
Patrik Wennberg
  • Function : Author
Anna Winkvist
  • Function : Author


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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Dates and versions

hal-01397737 , version 1 (17-07-2017)



Sanne A. E. Peters, Yvonne T. van Der 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, 2016, 23 (16), pp.1755-1765. ⟨10.1177/2047487316658571⟩. ⟨hal-01397737⟩
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