Association between age at first birth and risk of rheumatoid arthritis in women: Evidence from NHANES 2011-2020

PLoS One. 2025 Jan 16;20(1):e0317443. doi: 10.1371/journal.pone.0317443. eCollection 2025.

Abstract

Objective: This study focused on investigating the relation of age at first birth (AFB) with rheumatoid arthritis (RA) risk in women based on the 2011-2020 NHANES (National Health and Nutrition Examination Survey) data.

Methods: Women were analyzed using National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2020 in the US. Both AFB and RA diagnoses were obtained through self-reported questionnaires. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined using logistic regression models.

Results: Among the 7,449 women included in this study, 552 (7%) were diagnosed with RA. In comparison with women who had an AFB of 30-32 years (reference group), those who had an AFB < 18, 18-20, 21-23, 24-26, and > 35 years had the fully adjusted ORs and 95% CIs of 4.00 (95% CI 1.70, 9.40), 2.90 (95% CI 1.25, 6.73), 3.00 (95% CI 1.32, 6.80), 3.18 (95% CI 1.36-7.42), and 3.36 (95% CI 1.04-10.7), respectively. Due to the limitations inherent in cross-sectional studies, we have not observed significant differences in the risk of RA between women aged 27-29 and 33-35 at the AFB. Further research is warranted to refine these findings.

Conclusion: Women with an AFB < 26, or > 35 years have a higher risk of developing RA later in life. Policymakers may consider focusing more on women in these AFB age ranges in screening RA and making preventive measures.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Arthritis, Rheumatoid* / epidemiology
  • Female
  • Humans
  • Maternal Age
  • Middle Aged
  • Nutrition Surveys*
  • Odds Ratio
  • Pregnancy
  • Risk Factors
  • United States / epidemiology
  • Young Adult