Female Reproductive History and Risk of Age-Related Macular Degeneration: A Systematic Review and Meta-analysis

Several population-based studies have evaluated whether female reproductive history is associated with age-related macular degeneration (AMD), but the direction and magnitude of reported associations have been inconsistent. The review will focus on endogenous reproductive life-course factors rather than exogenous hormone therapy. The aim is to clarify whether reproductive history is associated with AMD and whether associations differ by AMD stage or subtype, without combining biologically distinct reproductive exposures into a single composite effect. The primary objective is to synthesize associations of age at menopause and reproductive lifespan with AMD. Secondary objectives are to synthesize, where data permit, associations of age at menarche, menopausal status/duration since menopause, parity/pregnancy history, lactation, and reproductive surgery with AMD.