Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Pregnancy Childbirth. 2021 Jan 7;21(1):28. doi: 10.1186/s12884-020-03499-2.
Most previous studies conducted in non-Middle Eastern populations have suggested that an increase in the number of parity/live birth(s) leads to cardiovascular disease (CVD) development, although their findings were inconclusive on this issue for both sexes. Biologic and socioeconomic pathways were suggested to explain this association. We studied this issue among urban Iranian men and women.
In this population-based cohort study, which included 3929 women and 2571 men aged ≥30 years, data for the number of parity/live birth(s) were obtained by a standard questionnaire. Participants were then annually followed for CVD events. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the number of parity/live birth(s) and other traditional CVD risk factors.
During more than 15 years of follow-up, 456 and 524 CVD events have occurred among women and men, respectively. Among women, a J-shaped association was found between the number of live births and incident CVD with the lowest risk for women with two live births. Among women in multivariable analyses, each unit increase in parity had a HR of 1.05 (CI: 1.01-1.10), and having ≥4 parity was associated with a HR of 1.86 (0.97-3.56, p-value = 0.061). Among men, in comparison with participants who had 1 child, multivariable HRs of having 2, 3, and ≥ 4 children were 1.97 (1.24-3.12), 2.08 (1.31-3.31), and 2.08 (1.30-3.34), respectively.
To the best of our knowledge, the current study is the first report on this issue in the Middle East and North Africa region, a region with a high burden of CVD. It can now be suggested that the number of parity/live birth(s) is linked to CVD among the Iranian population, with this issue being more prominent among men. Further research is needed to support our results and clarify the pathways between the number of parity/live birth(s) and CVD development among Iranian populations by considering potential risk factors, especially psycho-socio-economic risk factors.
大多数之前在非中东人群中进行的研究表明，生育次数的增加会导致心血管疾病（CVD）的发生，尽管他们的研究结果在男女两性对此问题上都没有定论。生物和社会经济途径被认为可以解释这种关联。我们在伊朗城市男性和女性中研究了这个问题。
在这项基于人群的队列研究中，包括 3929 名年龄≥30 岁的女性和 2571 名男性，通过标准问卷获得生育次数/活产数的数据。然后每年对参与者进行 CVD 事件随访。多变量 Cox 比例风险模型用于估计生育次数/活产数和其他传统 CVD 危险因素的风险比（HR）和 95%置信区间（CI）。
在超过 15 年的随访期间，女性和男性分别发生了 456 和 524 例 CVD 事件。在女性中，生育次数与 CVD 事件之间呈 J 型关联，生育两次的女性风险最低。在多变量分析中，生育次数每增加一个单位，HR 为 1.05（95%CI：1.01-1.10），生育次数≥4 次与 HR 为 1.86（0.97-3.56，p 值=0.061）相关。在男性中，与生育 1 个孩子的参与者相比，生育 2、3 和≥4 个孩子的多变量 HR 分别为 1.97（1.24-3.12）、2.08（1.31-3.31）和 2.08（1.30-3.34）。
据我们所知，这是中东和北非地区（该地区 CVD 负担沉重）首次对此问题进行的研究。现在可以认为，生育次数与伊朗人群的 CVD 有关，这一问题在男性中更为突出。需要进一步的研究来支持我们的结果，并通过考虑潜在的危险因素，特别是心理-社会经济危险因素，来阐明生育次数与伊朗人群 CVD 发展之间的关系。
