Emerging evidence has shown the association between female reproductive histories (e.g., menarche age, parity, premature and early menopause) and the risk of dementia. However, little attention has been given to infertility and pregnancy loss. To examine the associations of infertility, recurrent miscarriages, and stillbirth with the risk of dementia, this study used data from four cohorts in the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events. Women with data on at least one of the reproductive exposures of interest, dementia, and all covariates were included. Histories of infertility, miscarriage, and stillbirth were self-reported. Dementia (including Alzheimer’s disease) was identified through surveys, aged care, pharmaceutical, hospital, and death registry data. Cause-specific Cox regression models were used to estimate the hazard ratios of dementia, accounting for well-established risk factors of dementia, study variability, and within-study correlation. Overall, 291,055 women were included at a median (interquartile range) age of 55.0 (47.0–62.0) at baseline. During the median (interquartile range) follow-up period of 13.0 (12.0–14.0) years, 3334 (1.2%) women developed dementia. Compared to women without stillbirth, a history of recurrent stillbirths (≥ 2) was associated with 64% higher risk of dementia (adjusted hazard ratio = 1.64, 95% confidence interval: 1.46–1.85). Compared to women without miscarriage, women with recurrent miscarriages (≥ 3) were at 22% higher risk of dementia (adjusted hazard ratio = 1.22, 95% confidence interval: 1.19–1.25). These findings suggest that recurrent stillbirths is a risk factor for dementia and may need to be considered in risk assessment of dementia in women.

新的证据表明女性生育史（例如初潮年龄、产次、过早和过早绝经）与痴呆风险之间存在关联。然而，人们很少关注不孕症和流产问题。为了研究不孕症、反复流产和死产与痴呆症风险之间的关系，本研究使用了生殖健康和慢性病事件生命全程方法国际合作组织的四个队列的数据。包含至少一种相关生殖暴露、痴呆和所有协变量数据的女性。自我报告不孕、流产和死产史。痴呆症（包括阿尔茨海默病）是通过调查、老年护理、制药、医院和死亡登记数据来识别的。使用特定原因的 Cox 回归模型来估计痴呆症的风险比，考虑到痴呆症的既定风险因素、研究变异性和研究内相关性。总体而言，纳入了 291,055 名基线年龄中位（四分位距）为 55.0（47.0-62.0）的女性。在中位（四分位距）13.0（12.0-14.0）年的随访期内，3334 名（1.2%）女性患上了痴呆症。与没有死产的女性相比，反复死产史 (≥ 2) 的痴呆风险增加 64%（调整后风险比 = 1.64，95% 置信区间：1.46–1.85）。与没有流产的女性相比，反复流产（≥ 3 次）的女性患痴呆症的风险高出 22%（调整后的风险比 = 1.22，95% 置信区间：1.19–1.25）。这些发现表明，反复死产是痴呆症的一个危险因素，在女性痴呆症风险评估中可能需要考虑到这一因素。