Relationship between maximal respiratory pressures and multiple childbearing in Brazilian middle-aged and older women: A cross-sectional community-based study.

Ingrid Guerra Azevedo,Saionara Maria Aires Da Câmara,Catherine Mclean Pirkle,Elizabel De Souza Ramalho Viana,Álvaro Campos Cavalcanti Maciel,Christine E East

doi:10.1371/journal.pone.0208500

Ingrid Guerra Azevedo, Saionara Maria Aires Da Câmara + Show 4 more

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https://doi.org/10.1371/journal.pone.0208500

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Abstract

ObjectivePrevious studies show that multiparity and a number of chronic conditions are correlated among women. Also, low respiratory muscle strength has been associated to adverse health outcomes such as chronic lung disease and early mortality. This study aimed to investigate associations between the number of lifetime pregnancies and maximal inspiratory/expiratory pressures.MethodsIn a cross-sectional study, 204 women ages 41–80 years-old, from the rural community of Santa Cruz, Brazil, provided data regarding demographics, socioeconomic characteristics, health behaviors, and number of lifetime pregnancies (≤3, 4–6 or ≥7). Maximal respiratory pressures were measured with a digital manometer. Multiple linear regression analysis was used to examine the association of multiple childbearing on maximal respiratory pressures.ResultsOf the participants, 44.1% had ≤3 pregnancies, 30.4% had 4–6 pregnancies and 25.5% had >7 pregnancies. In the unadjusted analyses, maximal inspiratory and expiratory pressures varied significantly according to multiple childbearing categories. After adjustment, the values remained statistically significant only for maximal expiratory pressure. Compared to women with ≤3 lifetime pregnancies, those who had ≥7 pregnancies had significantly lower maximal expiratory pressure values (β = -18.07, p = 0.01)ConclusionMultiple childbearing appears to be negatively associated with maximal respiratory pressures; women with a higher number of lifetime pregnancies had lower values of maximal respiratory pressures when compared to those with fewer pregnancies. This association may be due to biomechanical changes in the respiratory muscles promoted by multiple lifetime pregnancies. This finding indicates a need to motivate women, from the prenatal to postpartum period, to safely exercise their respiratory muscles, including abdominal muscle exercises as well as respiratory muscle training.

Highlights

Aging is a dynamic and progressive process, influenced by physiological, socioeconomic, and biological factors [1,2]
Multiple linear regression analysis was used to examine the association of multiple childbearing on maximal respiratory pressures
Multiple childbearing appears to be negatively associated with maximal respiratory pressures; women with a higher number of lifetime pregnancies had lower values of maximal respiratory pressures when compared to those with fewer pregnancies

Summary

Introduction

Aging is a dynamic and progressive process, influenced by physiological, socioeconomic, and biological factors [1,2]. Among physiological factors linked to aging, numerous alterations in the respiratory system negatively impact respiratory volumes and capacities [3], contributing to the greater burden of morbidities commonly observed in this population [4]. Aging-associated alterations in the respiratory system that contribute to respiratory muscle strength decline may include pulmonary volumetric and thoracic changes [4,5]. Research shows a reduction in muscle mass and strength with age [6,7], which weakens peripheral (limbs) and respiratory muscles. Compared to younger adults, older adults show a reduction of up to 25% in their diaphragmatic strength [7] and some studies point to age as predictive for maximal respiratory pressures values, based on evidence that the older the subject, the lower the pressures [10,11,12,13]; there is evidence that shows small [14,15] or no relationship between MIP/MEP and age in older subjects [16], in older adults, some evidence points to an association between respiratory muscle strength and physical function [17,18], as measured with lower limb speed tests [19]

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