MECHANISMS IN ENDOCRINOLOGY: Parity and risk of type 2 diabetes: a systematic review and dose-response meta-analysis

Abstract

Objective: Epidemiologic studies regarding the association between parity and risk of type 2 diabetes have yielded inconsistent results. Therefore, we performed a systematic review and dose-response meta-analysis to determine the relation between parity and type 2 diabetes risk. Methods: We searched PubMed and Embase for published epidemiologic studies that assessed the relation between parity and risk of type 2 diabetes up to 31 March 2016. A dose-response random-effects model was used to combine study-specific relative risks (RRs) and 95% confidence intervals (CIs). Potential sources of heterogeneity were explored by meta-regression and subgroup analyses. Results: Seven cohort studies, 1 case-control study and 9 cross-sectional studies including 296 923 participants were eligible for inclusion. The combined RR for the highest versus lowest category of parity indicated a 54% increment in type 2 diabetes risk (95% CI: 29-83%). In the cubic spline model, a nonlinear association was found between parity and risk of type 2 diabetes (P = 0.02 for nonlinearity). Compared with nulliparous women, the estimated RR (95% CI) of type 2 diabetes for women with one to seven children was 1.01 (0

Effect of multiparity and ethnicity on the risk of development of diabetes: a large population‐based cohort study

“…We hypothesize that this may be attributable to the inclusion of women with decreased fertility in the 1-delivery group, who also had an increased risk of diabetes, such as women with polycystic ovary syndrome. Similar results were noted in a recent meta-analysis that showed a J-shaped relationship between parity and diabetes, with decreased risk with 1 pregnancy but increased risk after ≥3 pregnancies [30].…”

The Association Between Great-Grand Multiparity and the Development of Type 2 Diabetes Mellitus

“…Results of a large number of studies that have been published in the literature were similar to our study and a significant part of these studies have shown a statistically significant relationship between the development of multiparity and type 2 diabetes (15)(16)(17). Li et al (18) found a positive correlation between multiparity and type 2 diabetes development in a meta-analysis of 296,923 individuals that included 7 cohort studies, 1 case-control study, and 9 cross-sectional studies. In another study Rosario et al revealed that patients who delivered 6 and over children had a significantly higher risk of developing type 2 diabetes independent of family history, level of adiponectin and adipose tissue, and other risk factors (19).…”

Diabetes among Māori women with self‐reported past gestational diabetes mellitus in a New Zealand Māori community

“…Parity has been shown to have an effect on the risk of developing T2DM in women and so the comparison between those with and without self‐reported pGDM could have been affected by including nulliparous women in the group without past GDM. However, a recent meta‐analysis including 17 studies by Li et al . has suggested a non‐linear direct relationship between parity and T2DM risk, in which case we would not expect the results of our analysis to be greatly affected.…”