Abstract MP75: History of Infertility is Associated With Midlife Cardiovascular Health in Females

Abstract

Introduction: Infertility, the inability to conceive for ≥12mo (≥6mo if age ≥35y), has been associated with increased risk for adverse cardiometabolic outcomes, but risk related to specific domains of cardiovascular health remain unclear. Utilizing the American Heart Association’s Life’s Essential 8 (LE8) construct of cardiovascular health, we hypothesized that history of infertility would be associated with lower LE8 score (0-100) comprising four behavioral (diet, physical activity, sleep, smoking status) and four biological (BMI, blood pressure, blood lipids, glycemia) domains. Methods: Project Viva enrolled pregnant participants 1999-2002. We included participants who completed a midlife visit at approximately 18y postpartum (mean age 50.6y). Using multivariable linear regression, we examined relationships between any history of infertility (y/n) and mean LE8 overall, behavioral, biological, and individual component scores adjusted for race/ethnicity, education, household income, and age at midlife visit. Results: At midlife, 468 participants had complete data. The majority (67%, n=313) identified as non-Hispanic White and had a mean (± SD) LE8 overall score of 76.3 ± 12.2, behavioral score 76.5 ± 13.4, and biological score 76.0 ± 17.5. Overall, 35% (n=160) reported experiencing infertility in their lifetime. In adjusted models, estimated LE8 overall score was 3.3 points lower (β=-3.31, 95%CI -5.63, -0.98) compared to those with no history of infertility; a stronger association was detected for the biological (β=-4.64, 95%CI -8.13, -1.16) than the behavioral domain (β=-1.97, 95%CI -4.52 ,0.58). Of individual LE8 components, infertility was most strongly associated with a lower score for blood lipids (β=-8.77, 95%CI -15.1, -2.43) and glycemia (β=-4.84, 95%CI -8.71, -0.97) (Figure). Conclusion: A history of infertility was associated with lower overall and biological cardiovascular health scores and may indicate the need for enhanced cardio-preventive strategies during the reproductive years.