来自芬兰和瑞典的关于男性和女性早期疾病与终身不育之间关系的证据

Evidence from Finland and Sweden on the relationship between early-life diseases and lifetime childlessness in men and women

——原载《自然 – 人类行为》2024年第8卷第2期——

<Nature - Human Behaviour>, Volume 8, Issue 2, 2024

【摘要】一生中没有孩子的人的比例约为男性的25%，女性的比例约为20%。个体疾病与不育有关，尤其是女性，但我们缺乏对早期疾病对终生不育的影响的全面了解。我们调查了芬兰 (n = 1,035,928) 和瑞典 (n = 1,509,092) 1956-1968年（男性）和1956-1973年（女性）出生的所有个体，直至2018年完成生殖寿命。利用全国登记册，我们将社会人口统计数据与涉及16类414种疾病的生殖信息，使用人口和配对病例对照设计，对无子女不一致的兄弟姐妹（71,524名全姐妹和77,622名全兄弟）进行设计。早期疾病与终生不育最强的关联是精神行为障碍（尤其是男性）、先天性异常和内分泌-营养-代谢障碍（女性中最强）。我们还发现了炎症和自身免疫性疾病的新关联。关联取决于发病年龄，并由单身和教育程度调节。这一证据可用于了解疾病如何导致非自愿不育。

[Abstract] The percentage of people without children over their lifetime is approximately 25% in men and 20% in women. Individual diseases have been linked to childlessness, mostly in women, yet we lack a comprehensive picture of the effect of early-life diseases on lifetime childlessness. We examined all individuals born in 1956–1968 (men) and 1956–1973 (women) in Finland (n = 1,035,928) and Sweden (n = 1,509,092) to the completion of their reproductive lifespan in 2018. Leveraging nationwide registers, we associated sociodemographic and reproductive information with 414 diseases across 16 categories, using a population and matched-pair case–control design of siblings discordant for childlessness (71,524 full sisters and 77,622 full brothers). The strongest associations were mental–behavioural disorders (particularly among men), congenital anomalies and endocrine–nutritional–metabolic disorders (strongest among women). We identified new associations for inflammatory and autoimmune diseases. Associations were dependent on age at onset and mediated by singlehood and education. This evidence can be used to understand how disease contributes to involuntary childlessness.

论文原文：Aoxing Liu, Evelina T. Akimova, Xuejie Ding, Sakari Jukarainen, Pekka Vartiainen, Tuomo Kiiskinen, Sara Koskelainen, Aki S. Havulinna, Mika Gissler, Stefano Lombardi, Tove Fall, Melinda C. Mills & Andrea Ganna (2024). Evidence from Finland and Sweden on the relationship between early-life diseases and lifetime childlessness in men and women. Nature - Human Behaviour, Volume 8, Issue 2, Pages 276–287, February 2024.

https://doi.org/10.1038/s41562-023-01763-x

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