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In 1485 women with incident breast cancer recruited between 2014 and 2017, we examined birth cohort changes in reproductive factors, and used Cox models to examine whether reproductive characteristics were associated with all\u2010cause mortality after adjusting for confounders (age, stage, treatment, HIV, and social factors). Four years after diagnosis, 822 (56%) women had died. Median parity was 4 (IQR\u00a0=\u00a02, 6) and 209 (28%) of premenopausal women had had a recent birth (&lt;3\u2009years prior to cancer diagnosis). Each pregnancy was associated with a 5% increase (95% CI: 2%, 8%) in mortality rates, which held among postmenopausal women (5%, [1%\u20109%]). Pre\u2010menopausal women with a recent birth had 52% (20%, 92%) higher mortality rates. Fertility trends by birth cohort showed declining parity, increasing age at first birth and declining age at last birth, however the impact of these population\u2010level changes on future average survival was predicted to be very small (&lt;3% absolute gain).<\/jats:p>","DOI":"10.1002\/ijc.34411","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T08:57:04Z","timestamp":1671699424000},"page":"1804-1816","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Reproductive history and breast cancer survival: Findings from the African breast cancer\u2014Disparities in outcomes cohort and implications of Africa's fertility transition on breast cancer prognosis"],"prefix":"10.1002","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8896-0740","authenticated-orcid":false,"given":"Pauline","family":"Boucheron","sequence":"first","affiliation":[{"name":"International Agency for 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