Objective: The effect of pregnancy on otosclerosis is controversial. If pregnancy physiologically increases the risk of progression, females with children would be expected to receive stapedectomy earlier than childless females and males. Here, we seek to determine whether sex moderates the relationship between number of children and age at stapedectomy.
Study design: Retrospective observational study of national health care claims.
Setting: 2003 to 2016 Optum Clinformatics Data Mart.
Subjects and methods: In total, 6025 privately insured US adults (3553 females, 2472 males) who received stapedectomy for otosclerosis were queried for age and number of children at the time of initial surgery.
Results: The average age at stapedectomy was significantly lower in females than males (46.8 vs 48.1 years; t test, P < .0001). Females with children had a significantly lower age at surgery compared to childless females (39.3 vs 49.9 years; t test, P < .0001). Males with children similarly had a significantly lower age at surgery compared to childless males (40.5 vs 51.3 years; t test, P < .0001). A higher number of children was correlated with lower age for both females (Pearson, r = -0.3817, P < .0001) and males (Pearson, r = -0. 3675, P < .0001). Linear regression showed that younger age of surgery could be predicted by female sex and number of children (F(3, 6021) = 336.93, P < .001, R2 = 0.1437) with no significant interaction between sex and number of children (P = .186).
Conclusion: Sex does not moderate the effect of increasing number of children on decreasing age at stapedectomy. Social, rather than biological, factors surrounding parenthood such as increased overall health care utilization may explain prior associations between pregnancy and otosclerosis.
Keywords: claims data; otosclerosis; pregnancy; stapedectomy.