Résumé :
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[BDSP. Notice produite par INIST-CNRS 5DR0xbNK. Diffusion soumise à autorisation]. Knowledge is limited on mortality of grand multiparous women (>=5 deliveries), whose hormonal, metabolic, and social conditions differ from the average. The authors studied overall and cause-specific mortality in 1974-2001 among 87,922 grand multiparous women including 3,678 grand grand multiparous women (>10 deliveries) in Finland. Standardized mortality ratios were defined as ratios of observed to expected numbers of deaths, both derived from national cause-of-death files. During follow-up, 18,870 grand multiparous women and 625 grand grand multiparous women died (standardized mortality ratios (SMRs)=0.95 and 1.01, respectively). Decreased mortality among grand multiparous women was found for cancers of the breast (SMR=0.64,95% confidence interval (Cl) : 0.59,0.69), corpus uteri (SMR=0.68,95% Cl : 0.56,0.80), ovary (SMR=0.68,95% Cl : 0.60,0.75), bladder (SMR=0.59,95% Cl : 0.41,0.82), and respiratory tract (SMR=0.80,95% Cl : 0.72,0.88). The only malignant tumor associated with elevated mortality was kidney cancer (SMR=1.38,95% Cl : 1.21,1.56). The standardized mortality ratio was also low for dementia (SMR=0.78,95% Cl : 0.72,0.84), respiratory diseases (SMR=0.80,95% Cl : 0.75,0.85), and accidents and violent causes (SMR=0.79,95% Cl : 0.73,0.84). Mortality from diabetes mellitus (SMR=1.42,95% Cl : 1.29,1.55) and ischemic heart disease (SMR=1.10,95% Cl : 1.08,1.13) was increased. According to this study, overall mortality among grand multiparous women is not elevated. Low mortality from cancers is offset by higher mortality from cardiovascular conditions and diabetes mellitus.
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