Reproductive history and cardiovascular disease risk in postmenopausal women

Kleijn, Miriam J.J. de; Schouw, Yvonne T. van der; Graaf, Yolanda van der

doi:10.1016/s0378-5122(99)00038-9

Cited by 96 publications

(79 citation statements)

References 66 publications

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“…Despite research interest in the relationships between pregnancy-related factors (ie, birth weight, preeclampsia, gestational diabetes, preterm birth) and risk of CVD, 5,6,23,24 limited studies have examined the association of pregnancy loss and subsequent risk of CVD. 3,11,14,[25][26][27] Several early studies reported an association of miscarriage and/or stillbirth and risk of future CVD. 13,25,26 Although suggestive, these studies were not conclusive, because they were either descriptive, case-control, or cross-sectional studies, or they did not adjust for potential confounders.…”

Section: Discussionmentioning

confidence: 99%

“…3,11,14,[25][26][27] Several early studies reported an association of miscarriage and/or stillbirth and risk of future CVD. 13,25,26 Although suggestive, these studies were not conclusive, because they were either descriptive, case-control, or cross-sectional studies, or they did not adjust for potential confounders. In a nationally representative cross-sectional sample of 3,937 Finnish women aged 30 to 99 years, investigators examined the association of miscarriage with risk of CHD.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk of Cardiovascular Disease Among Postmenopausal Women with Prior Pregnancy Loss: The Women's Health Initiative

Parker

Lü

Sands-Lincoln

et al. 2014

The Annals of Family Medicine

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PURPOSE Metabolic, hormonal, and hemostatic changes associated with pregnancy loss (stillbirth and miscarriage) may contribute to the development of cardiovascular disease (CVD) in adulthood. This study evaluated prospectively the association between a history of pregnancy loss and CVD in a cohort of postmenopausal women.METHODS Postmenopausal women (77,701) were evaluated from 1993-1998. Information on baseline reproductive history, sociodemographic, and CVD risk factors were collected. The associations between 1 or 2 or more miscarriages and 1 or more stillbirths with occurrence of CVD were evaluated using multiple logistic regression.RESULTS Among 77,701 women in the study sample, 23,538 (30.3%) reported a history of miscarriage; 1,670 (2.2%) reported a history of stillbirth; and 1,673 (2.2%) reported a history of both miscarriage and stillbirth. Multivariable-adjusted odds ratio (OR) for coronary heart disease (CHD) for 1 or more stillbirths was 1.27 (95% CI, 1.07-1.51) compared with no stillbirth; for women with a history of 1 miscarriage, the OR = 1.19 (95% CI, 1.08-1.32); and for 2 or more miscarriages the OR = 1.18 (95% CI, 1.04-1.34) compared with no miscarriage. For ischemic stroke, the multivariable odds ratio for stillbirths and miscarriages was not significant. CONCLUSIONSPregnancy loss was associated with CHD but not ischemic stroke. Women with a history of 1 or more stillbirths or 1 or more miscarriages appear to be at increased risk of future CVD and should be considered candidates for closer surveillance and/or early intervention; research is needed into better understanding the pathophysiologic mechanisms behind the increased risk of CVD associated with pregnancy loss.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk of Cardiovascular Disease Among Postmenopausal Women with Prior Pregnancy Loss: The Women's Health Initiative

Parker

Lü

Sands-Lincoln

et al. 2014

The Annals of Family Medicine

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“…On the contrary, endothelial function improved in the second and third trimesters of the pregnancy, partly because of the increased concentration of HDL-C, which may inhibit the oxidation of low-density lipoprotein and thus protect the endothelium. These findings raise the question whether the increased risk of cardiovascular disease in multiparous women 2,3 is attributable rather to the burden of motherhood or other socioeconomic factors than to maternal hypercholesterolemia during pregnancy. The physiological short-term increase in serum lipids and improvement of endothelium-dependent vasodilation responses are associated with gestation rather than with each other.…”

Section: Clinical Implicationmentioning

confidence: 99%

“…It is not known whether the observed hyperlipidemia of pregnancy is atherogenic because clinical studies pertaining to parity present conflicting results: no association with, protection against as well as increase in the risk of cardiovascular disease. 2 However, the Framingham Heart Study reported that women with a history of more than 6 pregnancies had a significantly elevated risk of developing cardiovascular disease when compared with nulliparous women, at a relative risk of 1.6 (95% confidence interval 1.1-2.2). 3 Normal pregnancy is characterized by general vasodilatation and reduced systemic vascular resistance, mainly mediated by endothelium derived nitric oxide (NO).…”

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confidence: 99%

Pregnancy-Related Hyperlipidemia and Endothelial Function in Healthy Women

Saarelainen

Laitinen

Raitakari

et al. 2006

Circ J

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BackgroundThe purpose of the present study was to investigate pregnancy-related changes in the maternal serum lipid profile and endothelial function. Methods and ResultsAs part of the population-based, prospective cohort Cardiovascular Risk in Young Finns study conducted in Finland, 57 pregnant Finnish women and 62 control women matched for age and smoking were examined throughout gestation. Serum triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined and concomitantly endothelium-dependent brachial artery flow mediated dilation (FMD) was measured by ultrasound. During pregnancy serum TC, LDL-C, HDL-C, TG and very-low-density lipoprotein cholesterol increased significantly when compared with the non-pregnant state (p<0.001 for each) and towards the end of pregnancy (p<0.001, p<0.001, p=0.007, p<0.001, p<0.001). FMD increased towards the end of pregnancy and there was a statistically significant direct correlation between gestational age and FMD% (r=0.345, p=0.010). Brachial artery diameter at rest and FMD% were negatively correlated in pregnant (r=-0.280, p=0.035) and non-pregnant women (r=-0.360, p<0.004). The univariate correlation analysis showed a direct correlation between maternal serum TC (r=0.333, p=0.012) and TG (r=0.366, p=0.006) and FMD%, whereas a negative non-significant correlation was found in non-pregnant women. In a multivariate model, vessel size ( =-0.436, p=0.001) and TG ( =0.502, p<0.001) were the most powerful predictors for FMD% in pregnancy, the influence of other lipids was non-significant. Conclusions In healthy pregnant women increased gestational age is associated with improved endothelium-dependent vasodilation responses regardless of concurrently appearing lipid changes. (Circ J 2006; 70: 768 -772)

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“…Many studies have investigated the connection between the reproductive history of women and morbidity and mortality from cardiovascular diseases and have reported some controversial results [1,2]. Earlier studies have suggested a small but adverse effect of parity and gravidity on subsequent CVD [3][4][5][6][7][8] that may not become apparent until older ages.…”

Section: Introductionmentioning

confidence: 99%

Maternal Age at First Delivery and Risk of Cardiovascular Disease Later in Life

2013

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Background. To elucidate the association between maternal age at first delivery and cardiovascular health in women. Material and Method. A nationally representative survey, comprising 3,937 Finnish women aged 30-99 years with information on most of the potential cardiovascular disease (CVD) risk factors. Weighting survey analyses and logistic regression were performed. Results. Women who had their first delivery at age 25 or less had about five times higher odds ratio for myocardial infarction (fully adjusted OR: 4.82; 95% CI: 1.39-16.75) and about 2-fold higher odds ratio of arrhythmia (fully adjusted OR: 1.82; 95% CI: 1.13-2.92) compared to those who were 31-35 years at their first delivery. Each one year younger maternal age at first delivery predicted a higher risk of myocardial infarction (age-adjusted OR = 1.12; 95% CI: 1.06-1.18), hypertension (age-adjusted OR = 1.05; 95% CI: 1.03-1.07), arrhythmia (age-adjusted OR = 1.03; 95% CI: 1.01-1.05), angina pectoris (age-adjusted OR = 1.06; 95% CI: 1.02-1.10), and heart failure (age-adjusted OR = 1.05; 95% CI: 1.01-1.10). Conclusion. Maternal earlier age at first delivery is related to subsequent development of CVD, especially myocardial infarction. Our findings suggest a need for additional care and monitoring for CVD and its risk factors in women who had their first delivery at young ages.

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Reproductive history and cardiovascular disease risk in postmenopausal women

Cited by 96 publications

References 66 publications

Risk of Cardiovascular Disease Among Postmenopausal Women with Prior Pregnancy Loss: The Women's Health Initiative

Risk of Cardiovascular Disease Among Postmenopausal Women with Prior Pregnancy Loss: The Women's Health Initiative

Pregnancy-Related Hyperlipidemia and Endothelial Function in Healthy Women

Maternal Age at First Delivery and Risk of Cardiovascular Disease Later in Life

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