A phenome-wide spectrum of morbidity and mortality risks related to the number of offspring among 0.5 million Chinese men and women: A prospective cohort study.
10.1097/CM9.0000000000003815
- Author:
Meng XIAO
1
;
Aolin LI
2
;
Canqing YU
2
;
Yuanjie PANG
2
;
Pei PEI
3
;
Ling YANG
4
;
Yiping CHEN
4
;
Huaidong DU
4
;
Yujie HUA
5
;
Junshi CHEN
6
;
Zhengming CHEN
4
;
Jun LYU
2
;
Liming LI
2
;
Dianjianyi SUN
2
Author Information
1. Women and Children's Hospital of Chongqing Medical University, Chongqing 401147, China.
2. Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
3. Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China.
4. Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK.
5. Suzhou Center for Disease Control and Prevention, Suzhou, Jiangsu 215004, China.
6. China National Center for Food Safety Risk Assessment, Beijing 100022, China.
- Collective Name:China Kadoorie Biobank Collaborative Group
- Publication Type:Journal Article
- Keywords:
Morbidity risk;
Mortality risk;
Offspring;
Phenome-wide
- MeSH:
Adult;
Aged;
Female;
Humans;
Male;
Middle Aged;
China/epidemiology*;
Morbidity;
Proportional Hazards Models;
Prospective Studies;
Risk Factors;
Family Characteristics;
Mortality;
East Asian People
- From:
Chinese Medical Journal
2025;138(22):2925-2937
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Prospective evidence on how offspring number influences morbidity and mortality remains limited. This study investigated the associations between number of offspring and morbidity and mortality risks among 0.5 million Chinese adults.
METHODS:By using data from the China Kadoorie Biobank (CKB; n = 512,723, an approximately 12-year follow-up), sex-stratified phenome-wide association study (PheWAS) analyses were conducted to investigate associations between offspring number (without vs . with offspring; more than one vs . one offspring) and risks of ICD10-coded morbidity and mortality. Sex-specific adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated by Cox proportional-hazards models.
RESULTS:Among 210,129 men and 302,284 women aged 30-79 years, 1,338,837 incident events were recorded. PheWAS results revealed that offspring number was associated with disease risks across multiple systems. Cox models showed that childless men ( vs . one offspring) had higher risks for nine of 36 diseases, while childless women for five of 37. Each additional offspring was associated with reduced risks of mental and behavioral disorders in men (aHR [95% CI] = 0.93 [0.87-0.98]) and both mental and behavioral disorders (aHR [95% CI] = 0.93 [0.89-0.97]) and breast cancer (aHR [95% CI] = 0.82 [0.78-0.86]) in women. However, each additional offspring was associated with a 4% increase in the risk of cholelithiasis and cholecystitis in women (aHR [95% CI] = 1.04 [1.02-1.07]). Among 282,630 patients, 44,533 deaths were documented. Childless patients had higher mortality risk in both men (aHR [95% CI] = 1.37 [1.28-1.47]) and women (aHR [95% CI] = 1.27 [1.15-1.41]). For men, each additional offspring reduced mortality by 4% (aHR [95% CI] = 0.96 [0.95-0.98]), while for women, the lowest risk was observed among those with three to four offspring ( Pnonlinear <0.0001).
CONCLUSIONS:Offspring number is closely linked to morbidity and mortality risks. Further research is warranted to verify our findings and clarify the underlying mechanisms involved.
