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Pregnancy loss, high number of live births increase CVD risk
Compared with women who had one to two prior births, women who had pregnancies with no live births were at greater risk for CHD and HF, whereas women who had five or more live births were at greater risk for CHD and MI, according to a study published in the Journal of Women’s Health.
“Conditions such as heart disease and stroke together are the leading cause of death in women in the developed world, and it is essential that we understand why this is the case,” Clare Oliver-Williams, PhD, of the department of public health and primary care at the University of Cambridge, U.K., and a junior research fellow at Homerton College, U.K., said in a press release. “Our work suggests that there is a relation between cardiovascular disease risk and both pregnancy loss and having a large number of births.”
To assess the relationship between childbirth, pregnancy and subsequent risk for CVD, researchers examined data from 8,583 women aged 45 to 64 years who had participated in the ARIC study, which collected information regarding CHD, MI, HF and strokes between 1987 and 2016.
Throughout the study period, participants had six clinical examinations. At visit one, women reported the total number of live births they experienced, and then, at visit three, they reported whether they had ever been pregnant and the number of months they breastfed. Researchers used these responses to categorize the women into one of five groups: never pregnant (6%), pregnant with no live births (1.6%), one or two live births (36.2%), three or four live births (36.4%) or at least five live births (19.7%).
In addition, participants reported hospitalizations for CV events annually.
During the nearly 30-year follow-up period, 1,352 CHDs, 843 MIs, 750 strokes and 1,618 HF events occurred.
After adjusting for baseline sociodemographic, clinical and lifestyle factors, the researchers found that women who had prior pregnancies but no live births had greater incident CHD (HR = 1.64; 95% CI, 1.14-2.42) and HF risk (HR = 1.46; 95% CI, 1.04-2.05) than women with one to two live births.
It was also determined that women with five or more live births had greater risk for CHD (HR = 1.29; 95% CI, 1.1-1.52) and hospitalization for MI (HR = 1.38; 95% CI, 1.13-1.69) than women with one to two live births after adjusting for baseline characteristics and breastfeeding.
“This study isn’t designed to stress and worry women, especially those who have experienced the distress of pregnancy loss,” Oliver-Williams said in the release. “Instead, we want to empower women with knowledge that will help them to reduce their risk.
“Most women know by the age of 40 how many children and pregnancy losses they have had, which is years before most heart attacks and strokes occur. This provides a window of opportunity to make lifestyle changes, such as exercise and diet, that can help reduce the risk of cardiovascular disease,” she said. – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.