Parity and Metabolic Syndrome Risk: A Systematic Review and Meta-Analysis of 15 Observational Studies With 62,095 Women

BACKGROUND: Epidemiological studies have provided inconsistent evidence of the association between parity and metabolic syndrome (MetS) risk. We conducted this first systematic review and meta-analysis to comprehensively and precisely quantify this topic. METHODS: Comprehensive searches of PubMed, Embase, and the Web of Science databases were conducted to identify observational studies of the association between parity and MetS risk up to 30 January 2022. Study inclusion, data extraction, and quality assessment were checked and reviewed by two investigators independently. Random-effects models were applied to estimate pooled odds ratios (ORs) and 95% CIs. This study has been registered with PROSPERO. RESULTS: Two high-quality cohorts and thirteen medium-quality cross-sectional studies involving 62,095 women were finally included. Compared with the nulliparous, the pooled OR of MetS for the ever parity was 1.31 (95% CI = 0.91–1.88, I(2) = 72.6%, n = 3). Compared with the lowest parity number, the pooled OR of MetS for the highest parity number was 1.38 (95% CI = 1.22–1.57, I(2) = 60.7%, n = 12). For the dose-response analysis, the pooled OR of MetS for each increment of one live birth was 1.12 (95% CI = 1.05–1.19, I(2) = 78.6%, n = 6). These findings were robust across subgroups and sensitivity analyses. No evidence of heterogeneity between subgroups was indicated by meta-regression analyses. CONCLUSION: The findings suggested that parity was associated with an increased risk of MetS. A sufficient number of large prospective cohort studies are required to fully verify our findings. SYSTEMATIC REVIEW REGISTRATION: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022307703].