Association between parity and markers of inflammation: The multi-ethnic study of atherosclerosis

Abstract

IntroductionMultiparity has been associated with increased risk of cardiovascular disease (CVD). Inflammation may be a mechanism linking parity to CVD. We investigated the association between parity and later-life markers of inflammation.MethodsWe studied 3,454 female MESA participants aged 45–84, free of CVD, who had data on parity and inflammatory markers. Parity was categorized as 0 (reference), 1–2, 3–4, or ≥5. Linear regression was used to evaluate the association between parity and natural log-transformed levels of fibrinogen, D-dimer, GlycA, high sensitivity C-reactive protein (hsCRP), and interleukin-6 (IL-6).ResultsMean age was 62 ± 10 years. The proportion of women with nulliparity, 1–2, 3–4, and ≥5 live births were 18, 39, 29, and 14%, respectively. There was no association between parity and fibrinogen. Women with grand multiparity (≥5 live births) had 28, 10, and 18% higher levels of hsCRP, IL-6 and D-dimer, respectively, compared to nulliparous women, after adjustment for demographic factors. After additional adjustment for CVD risk factors, women with 1–2 and 3–4 live births had higher hsCRP and women with 1–2 live births had higher GlycA.ConclusionIn this diverse cohort of middle-to-older aged women, we found that higher parity was associated with some inflammatory markers; however, these associations were largely attenuated after adjustment for CVD risk factors. There was no clear dose-response relationship between parity and these inflammatory markers. Future studies are needed to evaluate how inflammation may influence the link between parity and CVD and whether healthy lifestyle/pharmacotherapies targeting inflammation can reduce CVD risk among multiparous women.Clinical trial registrationThe MESA cohort design is registered at clinicaltrials.gov as follows: https://clinicaltrials.gov/ct2/show/NCT00005487.

The association between parity and hypertension: a cross-sectional, community-based study

“…Parity exposes women to the risk of clinical placental syndrome (pregnancy loss, foetal growth restriction, and pre-eclampsia) as a result of altered uterine and intervillous blood flow, which is linked to inflammatory processes that lead to maternal vascular endothelial dysfunction and permanent vascular damage, thereby accelerating the development of atherosclerosis, hypertension, and cardiovascular diseases ( 35 ). Higher parity has been associated with increases in some inflammatory markers (fibrinogen, D-dimer, GlycA, high-sensitivity C-reactive protein, and interleukin-6 levels), which reflect increased risks of cardiovascular diseases and metabolic syndrome ( 36 ). In addition, the loss of the protective effect of oestrogen in postmenopausal women might lead to endothelial dysfunction and increased BMI, which are the main negative indicators of hypertension, particularly among women aged >50 years ( 37 ).…”

Childhood Racism and Cardiometabolic Risk in Latina Mothers Across the First Postpartum Year

“…Selected covariates (maternal age, maternal education, breastfeeding, parity, poverty, pregnancy at T3, BMI) have been previously associated with CRP and/or postmigration generational differences in Latinas (55)(56)(57)(58). Maternal education was coded in four categories from (1 = less than high school) to (4 = college degree or higher).…”