Higher parity is associated with increased risk of Type 2 diabetes mellitus in women: A linear dose-response meta-analysis of cohort studies

J Diabetes Complications. 2017 Jan;31(1):58-66. doi: 10.1016/j.jdiacomp.2016.10.005. Epub 2016 Oct 8.

Abstract

Aim: The goal of this study is to investigate the association between higher parity and the risk of occurrence of type 2 diabetes mellitus (T2DM) in women and to quantify the potential dose-response relation.

Methods: We searched MEDLINE, and EMBASE electronic databases for related cohort studies up to March 10th, 2016. Summary rate ratios (RRs) and 95% confidence intervals (CIs) for T2DM with at least 3 categories of exposure were eligible. A random-effects dose-response analysis procedure was used to study the relations between them.

Results: After screening a total of 13,647 published studies, only 7 cohort studies (9,394 incident cases and 286,840 female participants) were found to be eligible for this meta-analysis. In the category analysis, the pooled RR for the highest number of parity vs. the lowest one was 1.42 (95% CI: 1.17-1.72, I2=71.5%, Pheterogeneity=0.002, Power=0.99). In the dose-response analysis, a noticeable linear dose-risk relation was found between parity and T2DM (Pfor nonlinearity test=0.942). For every live birth increase in parity, the combined RR was 1.06 (95% CI: 1.02-1.09, I2=84.3%, Pheterogeneity=0.003, Power=0.99). Subgroup and sensitivity analyses yielded similar results. No publication bias was found in the results.

Conclusion: This meta-analysis suggests that higher parity and the risk of T2DM show a linear relationship in women.

Keywords: Cohort studies; Dose–response; Meta-analysis; Parity; Type 2 diabetes mellitus.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adult
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / etiology*
  • Female
  • Humans
  • Middle Aged
  • Parity / physiology*
  • Pregnancy
  • Reproductive History
  • Risk Factors