美國女性出生月份、出生季節與總死亡率及心血管疾病死亡率關係
作者：
小柯機器人發布時間：2019/12/20 14:48:13
美國布列根和婦女醫院和哈佛醫學院Eva S Schernhammer小組研究了出生月份、出生季節與美國女性的總死亡率和心血管疾病死亡率的關係。2019年12月18日，國際知名學術期刊《英國醫學雜誌》發表了這一成果。
為評價出生月份、出生季節與美國女性總死亡率和心血管疾病死亡率之間的關係，探討家庭和社會經濟因素在其中的作用，研究組在1976年建立護士健康研究，以進行前瞻性隊列研究。參與者為116911名女護士，在1976-2014年間註冊，均有詳細的出生日期信息。
經過38年，研究組共隨訪了4136364人年，期間有43248例參與者死亡，包括8360例心血管疾病相關死亡。在校正的多變量分析中，未觀察到出生月份、出生季節和總死亡率之間的顯著相關性。
與11月份出生的女性相比，3-7月份出生的女性心血管疾病死亡率增加。4月份出生的女性心血管疾病死亡率最高，12月份最低，相對差異為17.89%。春季和夏季出生的女性心血管死亡率顯著高於秋季。對家庭和社會經濟因素校正後，該結果不變。最低和最高危險季節的相對差異為10%。
總之，春夏季（尤其是3-7月份）出生的女性心血管特異性死亡率有所上升。但出生季節對女性總死亡率無影響。仍需進一步研究來揭示出生季節影響心血管疾病死亡率的機制。
附：英文原文
Title: Birth month, birth season, and overall and cardiovascular disease mortality in US women: prospective cohort study
Author: Yin Zhang, Elizabeth E Devore, Susanne Strohmaier, Francine Grodstein, Eva S Schernhammer
Issue&Volume: 2019/12/18
Abstract:
Objectives To evaluate the associations between birth month, birth season, and overall and cardiovascular disease mortality, and to examine the role of familial and socioeconomic factors in these associations.
Design Prospective cohort study.
Setting Nurses』 Health Study, established in 1976, an ongoing prospective cohort study in the United States.
Participants Female registered nurses who reported information on date of birth at study enrolment (n=116 911, 1976-2014, followed for 38 years).
Exposure Birth month and astronomical birth season (based on solstices and equinoxes as boundaries of the season categories).
Main outcome measures Age and various multivariable adjusted hazard ratios and 95% confidence intervals for the association between birth months (using November as the reference), astronomical birth season (using autumn as the reference), and overall and cardiovascular disease specific mortality were assessed using Cox proportional hazards models.
Results Among study participants, 43 248 overall deaths were documented during 4 136 364 person years of follow-up since enrolment, including 8360 cardiovascular disease related deaths. In fully adjusted multivariable analyses, no significant association was observed between birth month, birth season, and overall mortality. Compared with women born in November, increased cardiovascular disease mortality was observed among those born from March to July (hazard ratio for March, 1.09, 95% confidence interval 0.98 to 1.21; April, 1.12, 1.00 to 1.24; May, 1.08, 0.98 to 1.20; June, 1.07, 0.96 to 1.19; and July 1.08, 0.98 to 1.20). Those born in April had the highest cardiovascular disease mortality, and those born in December had the lowest (December, 0.95, 0.85 to 1.06). The relative difference between the lowest and highest risk month was 17.89%. Women born in spring (1.10, 1.04 to 1.17) and summer (1.09, 1.03 to 1.16) had a higher cardiovascular disease mortality than women born in the autumn. Adjustment for familial and socioeconomic factors did not change these results. The relative difference between the lowest and highest risk season was 10.00%.
Conclusion Participants born in the spring and summer (especially those born in March-July) had a slight but significant increase in cardiovascular disease specific mortality. However, no seasonal birth month effect was observed among women for overall mortality. Familial and socioeconomic factors did not appear to alter these associations. Further studies are required to confirm these findings and reveal mechanisms of these seasonal birth month effects in cardiovascular disease mortality.
DOI: 10.1136/bmj.l6058
Source: https://www.bmj.com/content/367/bmj.l6058