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Pregnancy history fails to influence cognitive function
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A large cohort of older women who reported at least one pregnancy performed no differently on a series of cognitive assessments over 28 years than women who had never been pregnant, according to findings published in Menopause.
“Overall, this study of older women found few differences in cognitive function by pregnancy history,” Donna Kritz-Silverstein, PhD, a professor in the department of family medicine and public health at the University of California, San Diego, and colleagues wrote in the study background. “Women who reported a pregnancy had a slightly faster episodic memory decline than women who had never been pregnant, but this difference amounted to recalling approximately one less word over a 10-year increase in age, a difference that would not survive correction for multiple comparisons, and is of negligible clinical significance.”
Kritz-Silverstein and colleagues analyzed data from 1,025 older women who participated in the Rancho Bernardo Study of Healthy Aging, a prospective cohort study that enrolled more than 6,000 men and women between 1972 and 1974. Researchers followed the cohort with annual mailed surveys and clinic visits approximately every 4 years through 2016. Reproductive history was assessed during the interview portion of the 1988 to 1992 visit; questions included age at menarche and menopause, number of pregnancies, ages at first and last pregnancy, number of live births, past oral contraceptive use (ever/never), and prior hysterectomy and/or oophorectomy. At each visit, participants completed four cognitive tests, including the Mini-Mental State Examination, the Trail Making Test Part B to test visuomotor tracking and mental flexibility, the Animals Naming Category Fluency Test to assess verbal memory and semantic fluency, and the Buschke-Fuld Selective Reminding Test to assess verbal episodic memory (mean age at baseline assessment, 73 years). Researchers used linear mixed-effects regression models to examine the association between pregnancy history and longitudinal change in cognitive function.
Within the cohort, 77% of women had at least one pregnancy. The number of pregnancies ranged from one to 14 (mean, 2.9). Age at first pregnancy ranged from 16 to 44 years (mean, 25 years). Age at last pregnancy ranged from 16 to 49 years (mean, 31 years). Compared with women with fewer pregnancies, women with at least four pregnancies reported higher rates of previous oral contraceptive use, being age 20 years or younger at first pregnancy and being age 35 years or older at last pregnancy.
Thirty-three percent of women completed one cognitive assessment, 21% completed two cognitive assessments, 23% completed three or four assessments, and 22% completed five or more cognitive assessments, the researchers wrote.
They found that women who reported ever being pregnant had a slightly faster rate of decline in episodic memory, recalling 0.12 fewer words per year of advancing age (P = .05) vs. women who had never been pregnant. Results persisted after adjustment for education and marital status. There were no significant associations between the number of pregnancies, age at first pregnancy or age at last pregnancy, and rate of decline across any cognitive function tests.
“In general, results from sensitivity analyses yielded similarly null results across all comparisons and suggested our main findings were robust,” the researchers wrote. – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.
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