Background: Multimorbidity has become an important public health problem in China, especially among middle-aged and elderly women. Few studies have been reported on the association between multimorbidity and female fertility, which is an important stage in the life course. This study aimed to explore the association between multimorbidity and fertility history among middle-aged and elderly women in China.
Methods: Data from 10,182 middle-aged and elderly female participants in the China Health and Retirement Longitudinal Study (CHARLS) in 2018 were used in this study. Multimorbidity was defined as the presence of at least two or more chronic conditions. Logistic regression analysis, negative binomial regression analysis, and restrictive cubic splines (RCSs) were used to analyze the relationship between female fertility history and multimorbidity or the number of chronic conditions. Multivariable linear regression was used to analyze the relationship between female fertility history and multimorbidity pattern factor scores.
Results: The results of this study showed that high parity and early childbearing were significantly associated with an increased risk of multimorbidity and an increased number of chronic conditions among middle-aged and elderly women in China. Late childbearing was significantly associated with reduced risk of multimorbidity and lessened diseases. Parity and age of first childbirth were significantly correlated with the odds of multimorbidity. The association between fertility history and multimorbidity was found to be influenced by age and urban-rural dual structure. Women with high parity tend to have higher factor scores of cardiac-metabolic, visceral-arthritic, and respiratory-psychiatric patterns. Women with early childbearing tended to have higher factor scores of the visceral-arthritic pattern and those with late childbearing tended to have lower factor scores of the cardiac-metabolic pattern.
Conclusion: Fertility history has a significant effect on multimorbidity in the middle and later lives of Chinese women. This study is of great importance for reducing the prevalence of multimorbidity among Chinese women through their life course and promoting health during their middle and later lives.
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http://dx.doi.org/10.3389/fpubh.2023.1090549 | DOI Listing |
JAMA Netw Open
December 2024
School of Pharmacy, University of Maryland, Baltimore.
Importance: Initiating effective therapy early is associated with improved survival among patients hospitalized with gram-negative bloodstream infections; furthermore, providing early phenotype-desirable antimicrobial therapy (PDAT; defined as receipt of a β-lactam antibiotic with the narrowest spectrum of activity to effectively treat the pathogen's phenotype) is crucial for antimicrobial stewardship. However, the timing of targeted therapy among patients hospitalized with gram-negative bloodstream infections is not well understood.
Objective: To compare the clinical outcomes between patients who were hospitalized with Enterobacterales bloodstream infections receiving early vs delayed PDAT.
JAMA Netw Open
December 2024
Hypertension Laboratory, Cardiovascular Disease Center of Guangdong Province, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Importance: Although cumulative evidence suggests that higher blood pressure (BP) and a greater burden of social determinants of health (SDOH) are associated with an increased risk of stroke, few studies have examined whether SDOH burden modifies the association between BP and stroke risk.
Objective: To evaluate whether the association between BP classification and stroke risk differs by SDOH burden among Chinese adults.
Design, Setting, And Participants: In this cohort study, analyses were conducted among 90 850 participants in the prospective subcohort of the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project, with recruitment from January 1, 2016, to December 31, 2020.
JAMA Netw Open
December 2024
Department of Emergency Medicine, Emory University, Atlanta, Georgia.
Importance: Recreational use of drug-soaked paper strips (hereafter, strips) in correctional facilities poses a major public health risk owing to the diverse and potentially severe toxic effects of the substances they contain. Understanding the clinical manifestations and outcomes of exposure to these strips is important for developing effective management and prevention strategies.
Objective: To characterize the clinical manifestations, management, and outcomes of intoxication from strips in a correctional facility population, and to identify the specific substances present in these strips.
Ned Tijdschr Geneeskd
December 2024
MUMC+, afd. Orthopedie, Joint-Preserving Clinic, Maastricht.
Middle-aged patients with early onset arthritis or cartilage defects are difficult to treat. These patients are relatively young for joint replacement and relatively old for regenerative therapies, i.e.
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