Abstract

Introduction: Although studies have demonstrated a J-shaped association of parity with cardiovascular disease, the association with vascular disease is not fully understood. We examined the association between parity and carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness. Hypothesis: Women who were never pregnant or had no live births and women with 5+ live births would have higher cfPWV and 5-year cfPWV change compared to women with 1-2 live births. Materials and Methods: We included 1220 women (average age 73.7; 21.9% Black) from the Atherosclerosis Risk in Communities - Neurocognitive Study, a cohort of 15,792 adults enrolled in 1987-1989 from four communities: Forsyth Co., NC; Jackson, MS; Minneapolis, MN; and Washington Co., MD. Technicians measured cfPWV at visit 5 (2011-13) and visit 6 or 7 (2016-19). At visit 2 (1990-92), women self-reported parity (number of prior live births), which we categorized as never pregnant or pregnant but no live births, 1-2 (referent), 3-4, and 5+ live births. We used linear regression models to evaluate associations of parity with visit 5 cfPWV and 5-year cfPWV change, adjusting for years between visits 5 and 6 or 7, age, race-center, education, body mass index, heart rate, mean arterial pressure, hypertension medication, and diabetes. Results: Participants reported having had no (7.7%), 1-2 (38.7%), 3-4 (40.0%), or 5+ (13.6%) prior live births. Women with 5+ live births had a higher visit 5 cfPWV (β=50.6 cm/s, 95% confidence interval (CI): 3.6-97.7 cm/s; Table) as compared to those with 1-2 live births. No statistically significant associations were observed for other parity groups and visit 5 cfPWV or cfPWV change. Conclusions: In later life, women with 5+ live births had higher arterial stiffness than those with 1-2 live births, but the rate of cfPWV change did not differ by parity. Longitudinal arterial stiffness measurements at mid-life are needed to better understand the effect of pregnancy on the trajectory of arterial stiffness among women in later life.

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