Reproductive Factors and the Risk of Open Angle Glaucoma in Women

Pr & eacute;cis: There was a significant inverse linear relationship between age at menopause and open angle glaucoma (OAG). Late menarche (>= 13 y) and a history of 5 or more deliveries were significantly associated with an increased risk of OAG.Purpose: To determine the association between reproductive factors including age at menarche, age at menopause, reproductive period, parity, and the risk of OAG in women.Methods: PubMed, Embase, Cochrane Library, and Web of Science were searched until February 9, 2022. Studies were included if they assessed the association between reproductive factors and OAG. The adjusted odds ratios (ORs) with relevant 95% CIs were extracted and pooled using fixed-effects models. Besides, we conducted dose-response analyses via the generalized least squares for trend method.Results: Seven articles including 18,618 women were identified in this review. The pooled results indicated that late age at menarche (>= 13 y) was significantly associated with an increased risk of OAG (OR=1.76, 95% CI: 1.28, 2.43). Early menopause (<45 y) also significantly elevated the risk of OAG (OR=1.89, 95% CI: 1.23, 2.90) in categorical meta-analyses, consistent with the inverse linear relationship between menopausal age and the risk of OAG in dose-response analyses (P=0.002). In addition, women who had delivered at least 5 children were at significantly higher risk of OAG compared with those nulliparous (OR=2.35, 95% CI: 1.02, 5.39), and a J-shape relationship between parity and OAG was observed in dose-response analyses (P<0.001).Conclusions: Late menarche (>= 13 y), early menopause (<45 y), and a history of 5 or more parturitions are possible risk factors for OAG. Longitudinal studies are warranted to further examine the relationships between reproductive factors and the risk of OAG.