Abstract

Introduction: Grand multiparity (≥5 live births) is associated with a future risk of cardiovascular disease (CVD). Inflammation also increases the risk for adverse CV outcomes and may be a mechanism linking parity to CVD. We aimed to investigate the association between parity and several markers of inflammation. Methods: We studied 3,454 female MESA participants (age 45-84 and free of CVD) who had data on parity and inflammatory markers measured at baseline. Parity (live births) was categorized as 0 (reference), 1-2, 3-4, or ≥5. Progressively adjusted linear regression models were 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). Results: Mean age at the baseline visit was 62±10 yrs. The proportion of women with nulliparity (0), 1-2, 3-4, and ≥5 live births were 620 (18%), 1357 (39%), 1004 (29%) and 473 (14%), respectively. There was no association between parity and fibrinogen. Women with grand multiparity had 28%, 10% and 18% higher levels of hsCRP, IL-6 and D-dimer, respectively, compared to nulliparous women, after adjustment for demographic factors (Model 1). Additionally, women with 1-2 and 3-4 live births had higher hsCRP and women with 1-2 live births had higher GlycA compared to nulliparous women in the fully adjusted model (Table). Conclusion: In this diverse cohort of mid-life women free from clinical CVD, we found a history of higher parity was positively associated with specific inflammatory markers; however, these associations were largely attenuated after adjustment for lifestyle and CVD risk factors. There was no clear dose-response relationship between higher parity status and higher inflammatory levels. Future studies are needed to evaluate how inflammation may influence the link between parity and CVD, and whether lifestyle/pharmacotherapy targeting inflammation can reduce CVD risk among multiparous women.

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