Parity and risk of subarachnoid hemorrhage in women: a nested case-control study based on national Swedish registries.

Abstract:

BACKGROUND AND PURPOSE:Subarachnoid hemorrhage (SAH) is the only type of stroke with female predominance, suggesting that reproductive factors may play a role in the etiology. We conducted a population-based study to examine the influence of parity on the risk of SAH in women. METHODS:We linked data from 3 national Swedish registries to identify first-ever hospitalizations for SAH in a cohort of women followed up since first childbirth during 1973-1997. Within this cohort, we conducted a nested case-control study and estimated the odds ratio (OR) and 95% CI of SAH by parity adjusted for age, calendar period, and length of follow-up. Information on smoking habits before the subject's first childbirth was available in a subset of the data (women with first childbirths during 1982-1997). RESULTS:Of the 887 cases identified, 70% had suffered from SAH > or =5 years after giving birth to their last child. The OR declined with increasing parity (1 child: reference; 2: OR=0.83 [95% CI, 0.70 to 0.99]; 3: OR=0.72 [95% CI, 0.58 to 0.91]; 4: OR=0.72 [95% CI, 0.48 to 1.08]; > or =5: OR=0.67 [95% CI, 0.32 to 1.41]). Adjusting for daily cigarette consumption before first childbirth in the subsample in which this information was available reduced but did not eliminate the association of the disorder with parity. CONCLUSIONS:Parity may confer a moderate long-term protective effect on the risk of SAH. The biological mechanism underlying this association is currently unknown.

journal_name

Stroke

journal_title

Stroke

authors

Gaist D,Pedersen L,Cnattingius S,Sørensen HT

doi

10.1161/01.STR.0000105933.16654.B4

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

28-32

issue

1

eissn

0039-2499

issn

1524-4628

pii

01.STR.0000105933.16654.B4

journal_volume

35

pub_type

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