Reproductive Lifespan and Adult-Onset Bronchiectasis in U.S. Postmenopausal Women: An Investigation of the Women’s Health Initiative Cohort
Year: 2026
Type: article
Abstract: Background: While bronchiectasis disproportionately affects post-menopausal women, the role of reproductive factors in its pathogenesis is not well characterized.We hypothesized that a shorter reproductive lifespan is associated with higher risk of bronchiectasis.Methods: We studied postmenopausal women in the Women's Health Initiative (WHI) study.The exposures included ages at menarche and menopause, and time between the two (reproductive lifespan).The outcome was the first incidence of bronchiectasis after Medicare enrollment, as reflected in the Medicare Claims Data.Incidence rates were calculated and a series of Cox proportional hazards models controlling for demographics, BMI, smoking, oophorectomy, hormone therapy (HT), oral contraceptives, and comorbid conditions were created.Results: Cumulative incidence of bronchiectasis in the cohort of 96,996 women was 2.7%.Shorter reproductive lifespan was associated with higher bronchiectasis risk (trend p=0.01).Women with the longest reproductive lifespan (≥40 years) were at 12% lower risk than those with the shortest reproductive lifespan (<30 years; aHR=0.88[95% CI: 0.77, 0.99]).HT modified this relationship (interaction p=0.04): shorter reproductive lifespan was associated with bronchiectasis risk only in the absence of HT (trend p=0.01).Without HT, women with the reproductive lifespans ≥40 years were at 22% lower risk of bronchiectasis than those with the reproductive lifespans <30 years (aHR=0.78[95% CI: 0.62, 0.94]).The use of HT was associated with a 19% greater risk of bronchiectasis (p<0.01).Interpretation: Longer reproductive lifespan is associated with reduced risk of bronchiectasis in post-menopausal women -but only in those without history of HT use.
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7163376260