Number of prior live births is associated with higher arterial stiffness but not its change in older women: the atherosclerosis risk in communities study

Alison N Bonner; Shantal Jayawickreme; Angela M Malek; Catherine J Vladutiu; Clare Oliver-Williams; Yamnia I Cortés; Hirofumi Tanaka; Michelle L Meyer

doi:10.3389/fcvm.2023.1172828

Number of prior live births is associated with higher arterial stiffness but not its change in older women: the atherosclerosis risk in communities study

Front Cardiovasc Med. 2023 May 23:10:1172828. doi: 10.3389/fcvm.2023.1172828. eCollection 2023.

Authors

Alison N Bonner¹, Shantal Jayawickreme¹, Angela M Malek², Catherine J Vladutiu³, Clare Oliver-Williams^{4

5}, Yamnia I Cortés⁶, Hirofumi Tanaka⁷, Michelle L Meyer⁸

Affiliations

¹ Medical Doctorate Program, University of North Carolina School of Medicine, Chapel Hill, NC, United States.
² Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States.
³ Department of Obstetrics & Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
⁴ Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
⁵ Central Bedfordshire Council, Chicksands, Bedfordshire, United Kingdom.
⁶ School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
⁷ Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, United States.
⁸ Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.

Abstract

Introduction: Although studies have demonstrated a J-shaped association between parity and cardiovascular disease (CVD), the association with arterial stiffness is not fully understood.

Methods: We examined the association between parity and carotid-femoral pulse wave velocity (cfPWV), a measure of central arterial stiffness. We conducted a longitudinal analysis of 1220 women (mean age 73.7 years) who attended the Atherosclerosis Risk in Communities Study visit 5 (2011-2013). At visit 2 (1990-1992), women self-reported parity (number of prior live births), which we categorized as: 0 (never pregnant or pregnant with no live births); 1-2 (referent); 3-4; and 5+ live births. Technicians measured cfPWV at visit 5 (2011-2013) and visit 6 or 7 (2016-2019). Multivariable linear regression modeled the associations of parity with visit 5 cfPWV and cfPWV change between visit 5 and 6/7 adjusted for demographics and potential confounding factors.

Results: Participants reported 0 (7.7%), 1-2 (38.7%), 3-4 (40.0%), or 5+ (13.6%) prior live births. In adjusted analyses, women with 5+ live births had a higher visit 5 cfPWV (β=50.6 cm/s, 95% confidence interval: 3.6, 97.7 cm/s) than those with 1-2 live births. No statistically significant associations were observed for other parity groups with visit 5 cfPWV or with cfPWV change.

Discussion: In later life, women with 5+ live births had higher arterial stiffness than those with 1-2 live births, but cfPWV change did not differ by parity, suggesting women with 5+ live births should be targeted for early primary prevention of CVD given their higher arterial stiffness at later-life.

Keywords: ARIC atherosclerosis risk in communities study; arterial stiffness (AS); longitudinal; parity; womens health.

Abstract

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