Correlation between Parity and Risk of Osteoarthritis in Elderly Women: A Retrospective Analysis

Osteoarthritis (OA), a leading cause of disability among elderly women, is influenced by both biological and lifestyle factors. Among these, reproductive history, especially parity, has emerged as a potential contributor. Hormonal fluctuations, weight gain during pregnancy, and cumulative mechanical stress on joints may predispose parous women to OA in later life. Despite increasing attention to this association, the extent to which parity contributes to OA risk in Indian women remains insufficiently explored.

This retrospective analytical study was conducted at a tertiary care hospital in India and included 234 postmenopausal women aged ≥60 years attending outpatient departments. Parity status was obtained from hospital records and patient interviews. Participants were categorized into three groups based on parity: nulliparous, low parity (1-3 children), and grand multiparous (≥4 children). The diagnosis of OA was confirmed using clinical criteria and radiographic evidence. Data were analyzed using the Statistical Package for the Social Sciences v25.0 with the Chi-square test. A P < 0.05 was considered statistically significant.

A total of 234 postmenopausal women with knee OA were included in the study. The mean age was 67.4 ± 5.2 years, with a mean BMI of 26.8 ± 3.4 kg/m2 and a mean postmenopausal duration of 17.3 ± 6.5 years. Diabetes mellitus and hypertension were present in 33.3% and 43.6% of participants, respectively. Based on the Kellgren-Lawrence grading, 46.2% had Grade 2 OA, 38.5% had Grade 3 OA, and 15.4% had Grade 4 OA. Regarding parity, 7.7% were nulliparous, 17.9% had low parity (1-2), 42.3% had moderate parity (3-4), and 32.1% were grand multiparous (≥5). A significant association was found between higher parity and increased severity of OA (P < 0.01), with grand multiparous women showing the highest proportion of Grade 4 OA (24.0%).

A significant positive correlation was observed between higher parity and the risk of developing OA in elderly women. Grand multiparity may serve as an independent risk factor for OA and should be considered in preventive strategies and early screening programs.