Abstract P194: Association of First Birth with Long-term Trajectories of Cardiovascular Health: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Abstract

Background: Pregnancy is the first major physiologic stress women will experience that may exacerbate cardiovascular risk factors. Little is known about how pregnancy impacts cardiovascular health (CVH), as defined by the AHA. We examined the effects of a first birth on trajectories of CVH in a community-based sample of biracial women. Methods: CARDIA is a longitudinal study of 5,115 black and white adults aged 18-30 years at enrollment (1985-86). CVH was defined as poor, intermediate and ideal levels of 6 of 7 available AHA factors (BMI, physical activity, smoking, blood pressure, glucose, and cholesterol) assigned scores of 0, 1, and 2, respectively. A modified CVH score (CVHS) was calculated as the sum of scores from individual health factors (range 0-14; higher score=greater CVH). We employed latent-class modeling to identify distinct trajectories in CVHS over 25 years of follow up after first birth. Results: Among 1,775 baseline nulliparas (59.1% white), 888 first live births occurred. In women with ≥1 birth (Figure 1a) and with no births (Figure 1b) there were 6 distinct CVHS trajectories and most tracked over time. Trajectory patterns were similar between women with and without a birth, and select groups experienced a rapid decline in CVHS (Figure 1a: groups 1,2,5; 1b: groups 1,2,3). There is no statistically significant difference in likelihood of group membership based on number of births or exam year of first birth (1a). Conclusion: Contrary to expectation, CVHS trajectories through adulthood do not differ markedly between women with and without live births. Future analyses among subgroups at risk for longer adverse effects are being evaluated.