מתוך medicontext.co.il
By Jill Stein
PHOENIX (Reuters Health) – Nulliparous women are at increased risk of developing postmenopausal hip fractures, according to results presented at the 23rd Annual Meeting of the American Society for Bone and Mineral Research (ASBMR).
Dr. Teresa A. Hillier, with the Kaiser Center for Health Research in Portland, Oregon, and colleagues looked at self-reported parity, the number of live births, and other potential fracture risk factors in 9699 postmenopausal women 65 years of age or older.
The frequency of hip and wrist fracture was assessed by contacting participants every 4 months after baseline and confirmed by physician review of medical records over a mean follow-up of 9.8 years. Vertebral fractures were determined by morphometric criteria on serial thoracic and lumbar X-rays over a mean follow-up of 3.7 years.
Nulliparous and parous women were similar with respect to baseline demographic characteristics, medications, and health status.
The results of univariate analysis showed that nulliparous women had an increased risk of hip and spine fractures compared with parous women. However, only hip fracture remained significant after a multivariate analysis that adjusted for factors thought to be related to hip fracture, including age, weight, height at age 25, and maternal history of hip fracture.
Overall, nulliparous women had a 45% increased risk of postmenopausal hip fractures independent of bone mineral density.
Among parous women, each additional birth conferred a protective effect against postmenopausal hip fracture, Dr. Hillier noted. "We found, in fact, that each additional birth was associated with a 14% decrease in the risk of postmenopausal hip fracture," she told Reuters Health.
The Portland investigator recommended that more studies be undertaken to identify potential mechanisms for the relationship of parity and reduced hip fractures, independent of factors such as altered hip geometry associated with pregnancy.
She also commented that it may be prudent for physicians to target their nulliparous patients for prevention strategies in light of the well-known increased risk of breast cancer and possibly osteoporotic fractures in this cohort.
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