The Association Between Parity and Subsequent Cardiovascular Disease in Women: The Atherosclerosis Risk in Communities Study.
Vladutiu, Catherine J
Loehr, Laura R
Rosamond, Wayne D
Stuebe, Alison M
J Womens Health (Larchmt)
Mary Ann Liebert Inc
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Oliver-Williams, C., Vladutiu, C. J., Loehr, L. R., Rosamond, W. D., & Stuebe, A. M. (2019). The Association Between Parity and Subsequent Cardiovascular Disease in Women: The Atherosclerosis Risk in Communities Study.. J Womens Health (Larchmt), 28 (5), 721-727. https://doi.org/10.1089/jwh.2018.7161
Background: Previous studies are inconclusive on the relationship between parity and cardiovascular disease (CVD), with few evaluating multiple cardiovascular outcomes. It is also unclear if any relationship between parity and CVD is independent of breastfeeding. We examined the associations between parity and cardiovascular outcomes, including breastfeeding adjustment. Materials and Methods: Data were from 8,583 White and African American women, 45-64 years of age, in the Atherosclerosis Risk in Communities Study. Coronary heart disease (CHD), myocardial infarction (MI), heart failure, and strokes were ascertained from 1987 to 2016 by annual interviews and hospital surveillance. Parity and breastfeeding were self-reported. Cox proportional hazards regression estimated hazard ratios (HR) for the association between parity and cardiovascular outcomes, adjusting for baseline sociodemographic, clinical and lifestyle factors, and breastfeeding. Results: Women reported no pregnancies (6.0%), or having 0 (1.6%), 1-2 (36.2%), 3-4 (36.4%), or 5+ (19.7%) live births. During 30 years follow-up, there were 1,352 CHDs, 843 MIs, 750 strokes, and 1,618 heart failure events. Compared with women with 1-2 prior births, those with prior pregnancies and no live births had greater incident CHD (HR = 1.64, 95% confidence interval 1.14-2.42) and heart failure risk (1.46, 1.04-2.05), after adjustment for baseline characteristics. Women with 5+ births had greater risk of CHD (1.29, 1.10-1.52) and hospitalized MI (1.38, 1.13-1.69), after adjustment for baseline characteristics and breastfeeding. Conclusions: In a diverse U.S. cohort, a history of 5+ live births is associated with CHD risk, specifically, MI, independent of breastfeeding. Having a prior pregnancy and no live birth is associated with greater CHD and heart failure risk.
Humans, Cardiovascular Diseases, Coronary Disease, Myocardial Infarction, Pregnancy Outcome, Proportional Hazards Models, Risk Factors, Cohort Studies, Follow-Up Studies, Parity, Breast Feeding, Pregnancy, Middle Aged, African Americans, European Continental Ancestry Group, United States, Female, Heart Failure, Stroke
This work was also supported by the British Heart Foundation Cambridge Centre of Excellence, (RE/13/6/30180) and Homerton College, University of Cambridge The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos. (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I).
British Heart Foundation (None)
External DOI: https://doi.org/10.1089/jwh.2018.7161
This record's URL: https://www.repository.cam.ac.uk/handle/1810/291480
Attribution 4.0 International
Licence URL: http://creativecommons.org/licenses/by/4.0/
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