Grundy E. Women's fertility and mortality in late mid life: a comparison of three contemporary populations. American Journal of Human Biology 2009; 21 (4 (Special Issue)): 541-547.

Evolutionary theory suggests a trade-off between reproduction and somatic maintenance implying a negative relationship between parity and longevity, at least in natural fertility populations. In populations in which fertility control is usual, there are also a number of mechanisms that may link reproductive careers and later mortality, but evidence of associations between women's fertility patterns and their later life health has been judged inconclusive due to varying controls for socio-economic characteristics and marital status. Here, we build on three recent studies that followed a common framework to investigate associations between women's parity and timing of first and last birth with mortality in late middle age in three contemporary developed counties, Norway, England and Wales, and the USA. Data were drawn from whole population registers (Norway); a large census-based record linkage study (England and Wales), and a nationally representative survey linked to death records (USA). Results show that teenage childbirth was associated with higher mortality risks in late middle age in all three countries. Risks of death were significantly raised among nulliparous women in Norway and England and Wales, and also raised (although not significantly so) for childless US women. However, although higher parity was associated with a slight mortality disadvantage in England and Wales and the USA, the reverse seemed the case in Norway. These finding suggest that in populations in which fertility control is usual, contextual factors influencing the relative costs and benefits of childbearing may influence associations between fertility histories and later mortality.