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.
J Clin Hypertens (Greenwich). 2021 Nov;23(11):2000-2008. doi: 10.1111/jch.14369. Epub 2021 Oct 17.
The effect of live birth/parity number on incident hypertension was investigated among Iranian parous women aged 30-70 years. The study population included 2188 normotensive women who were enrolled in 1999-2001. They were followed for incident hypertension (based on JNC 7 report) by 3-year intervals up to April 2018. Multivariable Cox proportional hazard models, adjusted for a wide set of potential hypertension risk factors, reproductive factors, and pregnancy complications, were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the number of parity/live birth(s) for incident hypertension. Additionally, as a sensitivity analysis, age-scale Cox regression was also done. During a median follow-up of 13.5 years, 935 incident hypertension have occurred. Compared to those with two live births, the participants who had 3 and ≥4 live births were at higher risk of hypertension development by the HRs of 1.25 [95% CI: 1.02-1.55] and 1.39 [1.12-1.72], respectively, in the full-adjusted model. Moreover, each additional live birth increased the risk of hypertension by a HR of 1.06 [95%CI: 1.02-1.11]. Results of parity number were also similar. Considering age as time scale also did not change the results generally. The authors found a significant interaction between live birth/parity number and age groups; the adverse effect of higher live birth/parity numbers on hypertension development was mainly found among those aged < 50 years. To sum up, compared to the live birth/parity number of two, Iranian women with ≥3 live birth/parity had a higher risk of incident hypertension; the issue was more prominent among younger mothers.
本研究旨在探讨伊朗生育过的 30-70 岁女性活产/分娩次数与高血压发病的关系。该研究纳入了 2188 名血压正常的女性，她们于 1999-2001 年入组。通过每 3 年一次的随访，直至 2018 年 4 月，以 JNC 7 报告为依据，确定高血压发病情况。采用多变量 Cox 比例风险模型，对广泛的潜在高血压危险因素、生育因素和妊娠并发症进行调整，以估计活产/分娩次数与高血压发病的风险比（HR）和 95%置信区间（CI）。此外，还进行了年龄尺度 Cox 回归敏感性分析。在中位随访 13.5 年期间，发生了 935 例高血压发病事件。与生育 2 次的参与者相比，生育 3 次和≥4 次的参与者发生高血压的风险更高，其 HR 分别为 1.25（95%CI：1.02-1.55）和 1.39（95%CI：1.12-1.72），在全调整模型中。此外，每增加一次活产，高血压发病风险增加 1.06（95%CI：1.02-1.11）。多胎妊娠的结果也相似。考虑年龄作为时间尺度也不会改变总体结果。作者发现活产/分娩次数与年龄组之间存在显著交互作用；较高的活产/分娩次数对高血压发病的不利影响主要发生在年龄<50 岁的人群中。综上所述，与生育次数为 2 次相比，伊朗生育≥3 次的女性发生高血压的风险更高；对于年龄较小的母亲，该问题更为突出。
