The association of parity with osteoarthritis and knee replacement in the Multicenter Osteoarthritis Study

Barton L Wise, J. Niu, Y. Zhang, D. T. Felson, L. A. Bradley, N. Segal, J. Keysor, M. Nevitt, Nancy E Lane

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: We evaluated the association of parity to both risk of knee replacement (KR) and knee osteoarthritis (OA). Design: The NIH-funded Multicenter Osteoarthritis Study (MOST) is a longitudinal observational study of persons age 50-79 years with either symptomatic knee OA or at elevated risk of disease. Baseline and 30-month knee radiographic OA (ROA) was defined as Kellgren/Lawrence (K/L) grade ≥2 or KR. Women were grouped based by number of births: 0; 1 (reference group); 2; 3; 4; and 5 or more. We examined the relation of parity to the incidence over 30 months of ROA and KR using a Poisson regression model. Generalized estimating equations (GEE) were used to control for correlation between two knees within a subject. We adjusted for age, BMI, race, education, occupation, baseline estrogen use, clinical site, injury, and for KR analyses WOMAC pain and use of pain medication. Results: Among 1618 women who reported parity information, mean age was 62.6 years, mean BMI 30.7kg/m2, mean WOMAC pain subscale score 3.7 at baseline. There were 115 KRs and 134 cases of incident knee ROA over 30 months. The relative risk of incident KR was 2.7 times as high (95% CI: 1.0, 7.3) and relative risk of incident knee ROA was 2.6 times as high (95% CI: 1.2, 5.3) among women with five to 12 children compared with those with one birth. Conclusion: Parity in women at risk for OA is associated with both incident ROA and KR, particularly for those with more than four children.

Original languageEnglish (US)
Pages (from-to)1849-1854
Number of pages6
JournalOsteoarthritis and Cartilage
Volume21
Issue number12
DOIs
StatePublished - Dec 2013

Fingerprint

Knee prostheses
Knee Osteoarthritis
Parity
Osteoarthritis
Multicenter Studies
Knee
Pain
Parturition
Knee Injuries
Education
Occupations
Observational Studies
Longitudinal Studies
Estrogens
Incidence

Keywords

  • Joint replacement
  • Knee
  • Osteoarthritis
  • Parity

ASJC Scopus subject areas

  • Biomedical Engineering
  • Orthopedics and Sports Medicine
  • Rheumatology

Cite this

The association of parity with osteoarthritis and knee replacement in the Multicenter Osteoarthritis Study. / Wise, Barton L; Niu, J.; Zhang, Y.; Felson, D. T.; Bradley, L. A.; Segal, N.; Keysor, J.; Nevitt, M.; Lane, Nancy E.

In: Osteoarthritis and Cartilage, Vol. 21, No. 12, 12.2013, p. 1849-1854.

Research output: Contribution to journalArticle

Wise, Barton L ; Niu, J. ; Zhang, Y. ; Felson, D. T. ; Bradley, L. A. ; Segal, N. ; Keysor, J. ; Nevitt, M. ; Lane, Nancy E. / The association of parity with osteoarthritis and knee replacement in the Multicenter Osteoarthritis Study. In: Osteoarthritis and Cartilage. 2013 ; Vol. 21, No. 12. pp. 1849-1854.
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AB - Objective: We evaluated the association of parity to both risk of knee replacement (KR) and knee osteoarthritis (OA). Design: The NIH-funded Multicenter Osteoarthritis Study (MOST) is a longitudinal observational study of persons age 50-79 years with either symptomatic knee OA or at elevated risk of disease. Baseline and 30-month knee radiographic OA (ROA) was defined as Kellgren/Lawrence (K/L) grade ≥2 or KR. Women were grouped based by number of births: 0; 1 (reference group); 2; 3; 4; and 5 or more. We examined the relation of parity to the incidence over 30 months of ROA and KR using a Poisson regression model. Generalized estimating equations (GEE) were used to control for correlation between two knees within a subject. We adjusted for age, BMI, race, education, occupation, baseline estrogen use, clinical site, injury, and for KR analyses WOMAC pain and use of pain medication. Results: Among 1618 women who reported parity information, mean age was 62.6 years, mean BMI 30.7kg/m2, mean WOMAC pain subscale score 3.7 at baseline. There were 115 KRs and 134 cases of incident knee ROA over 30 months. The relative risk of incident KR was 2.7 times as high (95% CI: 1.0, 7.3) and relative risk of incident knee ROA was 2.6 times as high (95% CI: 1.2, 5.3) among women with five to 12 children compared with those with one birth. Conclusion: Parity in women at risk for OA is associated with both incident ROA and KR, particularly for those with more than four children.

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