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Reproductive history and postmenopausal rheumatoid arthritis among women 60 years or older: Third National Health and Nutrition Examination Survey

Beydoun, Hind A. PhD1; el-Amin, Rawan DO, MPH2; McNeal, Malikah MPH1; Perry, Charleigh MPH1; Archer, David F. MD3

doi: 10.1097/GME.0b013e3182a14372
Original Articles

Objective Rheumatoid arthritis, a condition of unknown etiology, has been associated with considerable costs to society. The purpose of this study is to determine whether selected reproductive history characteristics are associated with postmenopausal rheumatoid arthritis diagnosis.

Methods Secondary analyses were performed using cross-sectional data from the Third National Health and Nutrition Examination Survey. Of 1,892 eligible participants, 182 fulfilled the criteria for postmenopausal rheumatoid arthritis, based on self-report and the 1987 American College of Rheumatology criteria. Logistic regression models were constructed, and odds ratios (ORs) with their 95% CIs were calculated for selected reproductive history characteristics as predictors of postmenopausal rheumatoid arthritis, after adjustment for potential confounders.

Results Multivariate logistic models suggested that age at menopause was the only reproductive characteristic that was significantly associated with the outcome of interest (OR, 0.96; 95% CI, 0.93-0.99). Compared with women experiencing menopause at 50 years of age or later, those who experienced menopause before 40 years of age (OR, 2.53; 95% CI, 1.41-4.53) had increased odds of postmenopausal rheumatoid arthritis.

Conclusions Women who experience menopause before 40 years of age seem to be at increased risk for postmenopausal rheumatoid arthritis. Conversely, age at menarche and pregnancy history may not predict rheumatoid arthritis after menopause. Further research is needed to confirm and elucidate these epidemiological findings.

From the 1Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA; 2West Virginia University School of Medicine, Morgantown, WV; and 3Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA.

Received May 28, 2013; revised and accepted June 18, 2013.

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Hind A. Beydoun, PhD, Graduate Program in Public Health, Eastern Virginia Medical School, Room 401, 651 Colley Avenue, Norfolk, VA 23501-1980. E-mail:

© 2013 by The North American Menopause Society.