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dc.contributor.authorOliver-Williams, Clare
dc.contributor.authorVladutiu, Catherine J
dc.contributor.authorLoehr, Laura R
dc.contributor.authorRosamond, Wayne D
dc.contributor.authorStuebe, Alison M
dc.date.accessioned2019-04-11T10:37:48Z
dc.date.available2019-04-11T10:37:48Z
dc.date.issued2019-05
dc.identifier.issn1540-9996
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/291480
dc.description.abstractBackground: 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.
dc.description.sponsorshipThis 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).
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherMary Ann Liebert Inc
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectHumans
dc.subjectCardiovascular Diseases
dc.subjectCoronary Disease
dc.subjectMyocardial Infarction
dc.subjectPregnancy Outcome
dc.subjectProportional Hazards Models
dc.subjectRisk Factors
dc.subjectCohort Studies
dc.subjectFollow-Up Studies
dc.subjectParity
dc.subjectBreast Feeding
dc.subjectPregnancy
dc.subjectMiddle Aged
dc.subjectAfrican Americans
dc.subjectEuropean Continental Ancestry Group
dc.subjectUnited States
dc.subjectFemale
dc.subjectHeart Failure
dc.subjectStroke
dc.titleThe Association Between Parity and Subsequent Cardiovascular Disease in Women: The Atherosclerosis Risk in Communities Study.
dc.typeArticle
prism.endingPage727
prism.issueIdentifier5
prism.publicationDate2019
prism.publicationNameJ Womens Health (Larchmt)
prism.startingPage721
prism.volume28
dc.identifier.doi10.17863/CAM.31527
dcterms.dateAccepted2018-10-12
rioxxterms.versionofrecord10.1089/jwh.2018.7161
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2019-05
dc.contributor.orcidOliver-Williams, Clare [0000-0002-3573-2426]
dc.identifier.eissn1931-843X
rioxxterms.typeJournal Article/Review
pubs.funder-project-idBritish Heart Foundation (None)
cam.issuedOnline2018-11-12


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International