Parity and cardiovascular disease risk among older women: how do pregnancy complications mediate the association?
OBJECTIVE
To determine whether parity is associated with increased risk of cardiovascular disease (CVD) after accounting for perinatal complications.


METHODS
CVD prevalence, number of births, and a history of preeclampsia, term low birth weight, preterm or stillbirth were evaluated among 540 women (mean age, 80 years; 47% black) enrolled in the Pittsburgh, PA site of the Health, Aging and Body Composition Study. Biomarkers were measured and CVD status was determined by self-report and hospital records.


RESULTS
Nulliparous women (n = 89) had lower CVD prevalence compared with parous women (18.0% vs. 30.2%). Parous women without perinatal complications of interest (n = 321) had higher statin use compared with nulliparas, a trend accompanied by lower high-density lipoprotein (HDL) and higher triglycerides among women with perinatal complications (n = 130). After adjustment, parous women with no complicated births had a 1.95-fold (95% confidence interval [CI], 1.03-3.7) higher CVD prevalence compared to nulliparas. Among women with one or more pregnancy complications, CVD prevalence was 2.67 times (CI, 1.34-5.33) higher. Women with five or more births had the highest CVD prevalence (odds ratio [OR], 2.60; CI, 1.17-5.76) that was attenuated to 2.27 (1.00-5.15) after adjustment for complications of interest.


CONCLUSIONS
History of pregnancy complications and higher statin use accounted for some but not all of the excess CVD prevalence among older parous women.
Catov
Janet M
JM
University of Pittsburgh, Department of Obstetrics, Gynecology & Reproductive Sciences, Pittsburgh PA 15213, USA. catovjm@upmc.edu
Newman
Anne B
AB
Sutton-Tyrrell
Kim
K
Harris
Tamara B
TB
Tylavsky
Francis
F
Visser
Marjolein
M
Ayonayon
Hilsa N
HN
Ness
Roberta B
RB
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008075:Lipoproteins, HDL / Q000097:blood; D010298:Parity; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014481:United States / Q000453:epidemiology
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008075:Lipoproteins, HDL; D014280:Triglycerides; D002784:Cholesterol