OP32 How are fertility patterns associated with changes in older women’s physical and mental health across europe?

Abstract

Background Aspects of fertility history such as early childbearing and high parity are associated with womens’ poorer later life physical and mental health. Few studies on the topic address health change longitudinally so little is known about whether health decline is accelerated for particular groups of mothers. Additionally most previous studies were based on single populations; cross-country comparisons are rare. This study aims to investigate associations between early childbearing and high parity and changes in physical and mental health over a 2–3 year interval among women aged 50–79 years in Europe. Methods We used data from eight countries for 5,762 women who participated in waves 1–3 of the Survey of Health, Ageing and Retirement in Europe (SHARE). Poor physical health at follow-up was measured by self-reports of having less than good self-rated health (SRH), functional limitations, and chronic illness. Poor mental health was indicated by having depressive symptoms, and being in the bottom quintile for cognitive functioning (mean of z-scores for word recall, delayed word list recall, verbal fluency and numeracy). Multivariable models were fitted for the health outcomes at follow-up while adjusting for baseline levels, with the main exposures being early childbearing ( Results Between baseline and follow-up, the proportion with functional limitations, chronic disease and low cognition increased, whereas the proportion with depression and less than good SRH decreased. Adjusted multivariable models showed that women who had been teenage mothers had higher odds of worse SRH (OR 1.74, 95% CI 1.40–2.17), and increased odds of functional limitations (OR 1.48 95% CI 1.06–2.06), chronic illness (OR 1.29 95% CI 1.03–1.61), and depressive symptoms (OR 1.39 95% CI 1.11–1.74) after 2–3 years of follow-up, compared to women who had delayed childbearing. High parity was not associated with changes in health. Adjustment for childhood and adult life factors reduced the associations with early childbearing but they remained statistically significant. There was no evidence that the effect of fertility history on health varied by region. Conclusion Early childbearing is associated with higher likelihood of physical and mental health decline among women 50–79 years in Western, Northern and Southern European countries. Further research could try to estimate the causal effect of fertility on health net of unobserved factors and to explore health declines over a longer period.