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Int. J. Environ. Res. Public Health 2015, 12(8), 9131-9140; doi:10.3390/ijerph120809131

Parity, Age at First Birth, and Risk of Death from Non-Hodgkin’s Lymphoma: A Population-Based Cohort Study in Taiwan

Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC 29201, USA
Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, No. 100 Shih-Chuan 1st RD, Kaohsiung 80708, Taiwan
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 12 June 2015 / Revised: 27 July 2015 / Accepted: 29 July 2015 / Published: 5 August 2015
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We undertook this study to examine whether there exists an association between parity and age at first birth and risk of death from non-Hodgkin’s lymphoma (NHL). Our sample included a total of 1,292,462 women who had a first and singleton childbirth between 1 January 1978 and 31 December 1987. We followed each subject from their first childbirth to 31 December 2009, and determined their vital status by merging natality data with Taiwan’s national death certificate database. Hazard ratios (HR) of death from NHL associated with parity and age at first birth were estimated using Cox proportional hazard regression models. In all, 412 NHL deaths were recorded during 34,980,246 person-years of follow-up. NHL mortality rate was 1.18 cases per 100,000 person-years. Older age at first birth (>23 vs. ≤23 years) was linked to an increased risk of death from NHL (adjusted HR = 1.41; 95% CI = 1.13–1.75). Controlling for age at first birth, the adjusted HR were 0.74 (95% CI = 0.55–0.98) for women with 2 births, and 0.71 (95% CI = 0.53–0.95) for women with 3 births or more, respectively, when compared with women with only 1 birth. A statistically significant downward trend in the adjusted HR for NHL death was detected with increasing parity (p for trend = 0.05). The HR of death from NHL was decreased by 7% (HR = 0.93; 95% CI = 0.87–0.99) for each additional parity. Our findings are consistent with reproductive factors (parity and early age at first birth) conferring a protective effect against the risk of NHL death. View Full-Text
Keywords: non-Hodgkin’s lymphoma; parity; mortality; cohort study non-Hodgkin’s lymphoma; parity; mortality; cohort study
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Chen, B.K.; Yang, C.-Y. Parity, Age at First Birth, and Risk of Death from Non-Hodgkin’s Lymphoma: A Population-Based Cohort Study in Taiwan. Int. J. Environ. Res. Public Health 2015, 12, 9131-9140.

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