Table 2.
Multivariable associations of gestational diabetes and hypertensive disorders of pregnancy during the first birth with natural menopause among 61,774 parous participants in the Nurses’ Health Study II, 1989–2019.
| Adverse pregnancy outcome | Early natural menopause (<45 years) | Natural menopausea | |||
|---|---|---|---|---|---|
| Model 1b | Model 2c | Model 2c | |||
| Casesd | Person-years | HR (95% CI) | HR (95% CI) | HR (95% CI) | |
| Gestational diabetes | |||||
| No | 1514 | 1,078,516 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Yes | 40 | 28,029 | 0.92 (0.67, 1.27) | 0.90 (0.65, 1.23) | 0.95 (0.89, 1.02) |
| Hypertensive disorders of pregnancy | |||||
| Normotensive | 1394 | 999,574 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Gestational hypertension | 44 | 33,423 | 0.89 (0.66, 1.21) | 0.85 (0.63, 1.15) | 0.95 (0.90, 1.01) |
| Preeclampsia | 116 | 73,548 | 1.17 (0.97, 1.42) | 1.11 (0.92, 1.35) | 0.93 (0.89, 0.97) |
Abbreviations: CI, confidence interval; HR, hazard ratio.
Onset of natural menopause: HR>1 indicates younger age at menopause; HR<1 indicates older age menopause.
Adjusted for age at first birth (continuous), age at baseline (continuous), race/ethnicity (African American, Hispanic, Asian, Caucasian, or other), maternal and paternal education (<9, 9–11, 12, 13–15, or ≥16 years), and pre-pregnancy factors of age at menarche (≤9, 10, 11, 12, 13, 14, 15, 16, or ≥17 years), physical activity at 18–22 years of age (never, 1–3, 4–6, 7–9, or 10–12 months per year), body mass index (weight (kg)/height (m)2; 15.0-<18.5, 18.5-<25.0, 25.0-<30, or 30.0-<50.0), alcohol consumption (none, ≤1/week, 2–6/week, or ≥1/day), smoking status (never, past, or current smoker), oral contraceptive use (none, <2, ≥2-<4, or ≥4 years), and infertility due to ovulatory disorder (no or yes).
Additionally adjusted for post-first birth factors of body mass index (weight (kg)/height (m)2; <18.5, 18.5-<25.0, 25.0-<30.0, ≥30.0), alcohol consumption (none, ≤1/week, 2–6/week, or ≥1/day), smoking status (never, past, or current smoker), infertility due to ovulatory disorder (no or yes), parity (continuous), and breastfeeding (<1, 1–3, >3–6, >6–12, >12–18, >18–24, >24–36, or >36 months).
Cases do not sum to 1763 because gestational diabetes and hypertensive disorders of pregnancy data were not collected for 8106 participants.