Parity and Risk of Cardiovascular Disease in Women over 45 Years in the United States: National Health and Nutrition Examination Survey 2007-2018

Objective: Current research results on the association between parity and cardiovascular disease (CVD) risk are inconclusive. The purpose of this study was to examine the relationship between parity and risk of CVD in women over 45 years of age.Materials and Methods: Data were from the National Health and Nutrition Examination Survey for 2007-2018. A total of 8,882 women >= 45 years of age were included. The exposure of parity referred to the number of live births, and the outcome variable was the occurrence of CVD events, including stroke, heart attack, coronary heart disease (CHD), heart failure, and angina. We performed logistic regression to calculate the unadjusted and adjusted odds ratios (ORs; 95% confidence intervals [CIs]) controlling for confounding factors.Results: Among 8,882 women, the mean age was 62.4 +/- 10.8 years, with a range of 45 to 80 years. The weighted prevalence of CVD, stroke, heart attack, CHD, heart failure, and angina in parous women were significantly higher than those of nulliparous women (p < 0.05). After adjusting for demographic factors, CVD risk factors, reproductive factors, the ORs of CVD with parity 1-2, 3-4, and 5+ were 1.85 (95% CI: 1.29-2.64), 1.70 (95% CI: 1.15-2.50), and 1.92 (95% CI: 1.28-2.88), respectively. The odds of stroke and heart attack were also significantly positively related to increasing parity compared with nulliparity. However, compared with nulliparity, parity of 3 was associated with a slightly lower risk of CVD.Conclusions: Our findings indicated that parity was significantly positively associated with CVD, giving birth to three children associated with a slightly lower risk compared with nulliparity. Further cohort studies are warranted to confirm the findings.

Automated summary

This study found that increasing parity was significantly associated with a higher risk of stroke and heart attack, while giving birth to three children was associated with a slightly lower risk of cardiovascular disease compared to nulliparity.