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IJE Advance Access originally published online on September 4, 2008
International Journal of Epidemiology 2009 38(1):312-318; doi:10.1093/ije/dyn174
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2008; all rights reserved.

Childbearing, breastfeeding, other reproductive factors and the subsequent risk of hospitalization for gallbladder disease

Bette Liu*, Valerie Beral, Angela Balkwill and on behalf of the Million Women Study Collaborators

Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK.

*Corresponding author. Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK. E-mail: bette.liu{at}ceu.ox.ac.uk


  Abstract

Background While parous women are known to be at an increased risk of gallbladder disease, little is known about the effects of other reproductive factors such as breastfeeding, age at menarche and age at menopause.

Methods The Million Women Study is a prospective cohort study of 1.3 million middle-aged women in England and Scotland recruited from 1996 to 2001. Participants were followed-up by record-linkage for a mean of 6.1 years for admissions to hospital. The adjusted relative risk of hospital admission for cholelithiasis, cholecystitis or cholecystectomy according to parity, breastfeeding, age at menarche and age at menopause was examined.

Results During follow-up of 1 289 029 eligible women, 25 111 were admitted to hospital for gallbladder disease, of whom 21 735 (87%) had a cholecystectomy. The hospital admission rate over 5 years for gallbladder disease was 1.6/100 women and for cholecystectomy was 1.4/100 women. The adjusted relative risk of gallbladder disease increased with increasing parity by 8% (95% CI 7–9%, P < 0.0001) for each birth. Among women of a given parity, breastfeeding reduced the risk of gallbladder disease, the relative risk decreasing by 7% (95% CI 5–10%, P < 0.0001) per year of breastfeeding. Women's age of menarche and age at menopause did not alter the risk of gallbladder disease (P = 0.4 and P = 0.3, respectively for linear trend).

Conclusion Hospitalization for gallbladder disease is common in middle-aged women. The risk increases the more children a woman has had, but decreases the longer she breastfeeds. The increased risk of gallbladder disease associated with having children can be offset by breastfeeding.

Keywords Gallbladder diseases, cholecystectomy, breastfeeding, parity, Million Women Study

Accepted 28 July 2008


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