Early Childbirth and Having No Children Linked to Higher Mortality in Postmenopausal Women, Study Shows

The research, led by Dr. Zailing Xing from the College of Public Health at the University of South Florida, examined data from over 100,000 women to understand how parity and age at childbirth relate to lifespan—finding that early childbirth and childlessness are linked to higher all-cause mortality, with premature menopause playing a key mediating role.

The study analyzed data from the Women’s Health Initiative, involving 106,760 postmenopausal women. Using propensity score matching and multilevel Cox proportional hazard models, the researchers assessed the association between different reproductive factors and mortality, adjusting for demographic and clinical variables. Mediation analysis was also conducted to explore the role of premature menopause in these associations.

The study led to the following findings:

• Women with no children had a 9% higher risk of all-cause mortality compared to those with two children.
• Women with only one child had an 11% higher risk of death later in life.
• Having three or more children did not significantly affect mortality rates.
• Women who gave birth to their first child before age 20 had a 14% increased risk of mortality.
• Last childbirth before age 25 was associated with a 6% higher risk of death.
• Last childbirth at or after age 40 was linked to a 7% higher mortality risk.
• Both early and late childbirth negatively impacted long-term survival.
• Premature menopause was identified as a significant mediator between reproductive history and mortality risk.
• Women with early childbirth or no children were more likely to experience early menopause.
• Early menopause was associated with a shorter lifespan among postmenopausal women.

The findings emphasize the potential long-term health implications of reproductive choices and timing. According to the authors, these results highlight the need for early identification of women who may be at increased risk due to their reproductive history. This could help guide interventions aimed at improving long-term health outcomes and survival.

The authors concluded, "The study sheds light on how early-life reproductive factors can shape a woman's health trajectory well into older age. Recognizing and addressing these risks early may be crucial to supporting healthy aging among women."

Reference: https://www.ajog.org/article/S0002-9378(25)00379-5/abstract