Reproductive History and Chronic Hepatic Steatosis in the Michigan Study of Women's Health Across the Nation

Abstract

Background: Reproductive history, particularly maternal age at most recent birth, may reflect lower risk for chronic disease and mortality due to socioeconomic factors, lifestyle behaviors, or genetics. Reproductive history has not been examined with respect to hepatic steatosis, the most common liver disease in the United States. Our objective was to examine the association between reproductive history and hepatic steatosis. Methods: We examined the association between reproductive history characteristics?specifically age at most recent birth?and the odds of moderate to severe hepatic steatosis using a population-based retrospective cohort study of women who underwent hepatic ultrasound at the Michigan site of the Study of Women's Health Across the Nation (n=331). Results: Women who gave birth at ≥35 years of age comprised 19% of the study population and were similar to other women regarding sociodemographic history and health behaviors. In multivariable analyses adjusting for age, race/ethnicity, chronic disease, and medications associated with hepatic steatosis, age at birth ≥35 years was associated with significantly decreased odds of hepatic steatosis (adjusted odds ratio [OR] 0.41, 95% confidence interval [CI] 0.20?0.87), which was attenuated after adjustment for waist circumference (OR 0.51, 95% CI 0.24?1.10). Other reproductive factors including gravidity, parity, miscarriages and abortions, recall of gestational weight gain, breastfeeding, age at first birth, and age at final menstrual period were not associated with hepatic steatosis. Conclusions: Women who were older at their most recent birth had a reduced odds of hepatic steatosis, possibly associated with their lower waist circumference.