Reproductive history and carotid intima-media thickness.
BACKGROUND
Intima-media thickness (IMT) of the carotid arteries is a valid measure of preclinical atherosclerosis which may predict cardiovascular outcomes. Metabolic and hormonal changes associated with the reproductive history of women may contribute to the development of cardiovascular disease (CVD).


METHODS
In a population-based cross-sectional study comprising 746 Finnish women, aged 45-74 years, associations of reproductive history (assessed by questionnaire) and measures of subclinical atherosclerosis (by ultrasonographic detection) were studied. Statistical methods included linear and logistic regression models.


RESULTS
Mean carotid IMT was positively associated with parity, but after adjustment for age its statistical significance disappeared. Women with a history of stillbirth tended to have higher IMT than other women. History of hysterectomy was an independent determinant of carotid plaque in models with age, blood pressure, fasting blood glucose and cholesterol, body mass index (BMI), education and smoking (odds ratio (OR): 0.32; 95% confidence interval (CI): 0.11-0.96). But when oophorectomy (yes/no) was included in the model, this association lost its statistical significance (adjusted OR: 0.36; 95% CI: 0.11-1.22). A history of stillbirth was associated with an increased age-adjusted risk of plaque (OR=3.43; 95% CI: 1.07-11.05), but in the fully adjusted model it lost its statistical significance (OR=3.61; 95% CI: 0.86-15.23).


CONCLUSIONS
Stillbirth was associated with increased risk of atherosclerotic plaque. Atherosclerosis is a lifelong process to which stillbirth is related. However, due to the cross-sectional design of this study, the causality of this association remains unclear.
Kharazmi
Elham
E
Tampere School of Public Health, University of Tampere, Tampere, Finland. elham.kharazmi@uta.fi
Moilanen
Leena
L
Fallah
Mahdi
M
Kaaja
Risto
R
Kattainen
Anna
A
Kähönen
Mika
M
Jula
Antti
A
Kesaniemi
Antero
A
Luoto
Riitta
R
D000368:Aged; D050197:Atherosclerosis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D012098:Reproduction; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography