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. 2025 Jan 16;20(1):e0317443.
doi: 10.1371/journal.pone.0317443. eCollection 2025.

Association between age at first birth and risk of rheumatoid arthritis in women: Evidence from NHANES 2011-2020

Hang Cui  1   2 , Chenyang Huang  1   2 , Yuntian Ye  1   2 , Tianci Guo  1   2 , Weijie Yu  1   2 , Puyu Niu  1   2 , Kuiliang Gao  1   2 , Jiajin Liu  1   2 , Aifeng Liu  1   2
Affiliations

Association between age at first birth and risk of rheumatoid arthritis in women: Evidence from NHANES 2011-2020

Hang Cui et al. PLoS One. .

Abstract

Objective: This study focused on investigating the relation of age at first birth (AFB) with rheumatoid arthritis (RA) risk in women based on the 2011-2020 NHANES (National Health and Nutrition Examination Survey) data.

Methods: Women were analyzed using National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2020 in the US. Both AFB and RA diagnoses were obtained through self-reported questionnaires. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined using logistic regression models.

Results: Among the 7,449 women included in this study, 552 (7%) were diagnosed with RA. In comparison with women who had an AFB of 30-32 years (reference group), those who had an AFB < 18, 18-20, 21-23, 24-26, and > 35 years had the fully adjusted ORs and 95% CIs of 4.00 (95% CI 1.70, 9.40), 2.90 (95% CI 1.25, 6.73), 3.00 (95% CI 1.32, 6.80), 3.18 (95% CI 1.36-7.42), and 3.36 (95% CI 1.04-10.7), respectively. Due to the limitations inherent in cross-sectional studies, we have not observed significant differences in the risk of RA between women aged 27-29 and 33-35 at the AFB. Further research is warranted to refine these findings.

Conclusion: Women with an AFB < 26, or > 35 years have a higher risk of developing RA later in life. Policymakers may consider focusing more on women in these AFB age ranges in screening RA and making preventive measures.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of participants.
From: Association between age at first birth and risk of rheumatoid arthritis in women: Evidence from NHANES 2011–2020.
Fig 2
Fig 2. From: Association between age at first birth and risk of rheumatoid arthritis in women: Evidence from NHANES 2011–2020.
See this image and copyright information in PMC

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References

    1. Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet. 2016. Oct 22;388(10055):2023–2038. doi: 10.1016/S0140-6736(16)30173-8 - DOI - PubMed
    1. Jin S, Li M, Fang Y, Li Q, Liu J, Duan X, et al.. Chinese Registry of rheumatoid arthritis (CREDIT): II. prevalence and risk factors of major comorbidities in Chinese patients with rheumatoid arthritis. Arthritis Res Ther. 2017. Nov 15;19(1):251. doi: 10.1186/s13075-017-1457-z - DOI - PMC - PubMed
    1. Alpízar-Rodríguez D, Pluchino N, Canny G, Gabay C, Finckh A. The role of female hormonal factors in the development of rheumatoid arthritis. Rheumatology (Oxford). 2017. Aug 1;56(8):1254–1263. doi: 10.1093/rheumatology/kew318 - DOI - PubMed
    1. van Vollenhoven RF. Sex differences in rheumatoid arthritis: more than meets the eye. BMC Med. 2009. Mar 30;7:12. doi: 10.1186/1741-7015-7-12 - DOI - PMC - PubMed
    1. Jiang LQ, Zhang RD, Musonye HA, Zhao HY, He YS, Zhao CN, et al.. Hormonal and reproductive factors in relation to the risk of rheumatoid arthritis in women: a prospective cohort study with 223 526 participants. RMD Open. 2024. Jan 1;10(1):e003338. doi: 10.1136/rmdopen-2023-003338 - DOI - PMC - PubMed