Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
Ann Epidemiol. 2022 Oct;74:43-50. doi: 10.1016/j.annepidem.2022.06.033. Epub 2022 Jun 28.
To evaluate the association of a history of infertility with long-term weight, body composition, and blood pressure.
We studied 1581 women from the prospective cohort Project Viva. History of infertility was based on self-reported time to pregnancy ≥12 months or use of medical treatment to conceive for the index or any prior pregnancy; a diagnosis of infertility; claims for infertility treatments/prescriptions abstracted from medical records. The outcomes were weight, waist circumference, and body fat assessed through 12 years postpartum; and blood pressure assessed through 3 years postpartum. We used linear mixed-effect models adjusted for age, race/ethnicity, income, education, marital status, parity, and age at menarche.
Three hundred forty-two women (21.6%) had a history of infertility. In adjusted models, women with versus without infertility, had higher average weight (3.29 kg, 95% confidence interval [CI]: 1.35-5.24), waist circumference (2.46 cm, 95% CI: 0.78-4.13) and body fat (1.76 kg, 95% CI: 0.09-3.43). Among younger (18-29 years), but not older (≥30 years) women, infertility was associated with higher systolic (4.08 mmHg, 95% CI: 0.93, 7.23) and diastolic blood pressure (2.16 mmHg, 95% CI: 0.11-4.20).
A history of infertility may serve as a marker to identify women at higher cardiometabolic risk.
评估不孕史与长期体重、身体成分和血压的关联。
我们研究了来自前瞻性队列研究项目 Viva 的 1581 名女性。不孕史基于自我报告的受孕时间≥12 个月或使用医疗手段受孕的时间，或既往妊娠的时间；不孕的诊断；从医疗记录中提取的不孕治疗/处方的索赔。结果是产后 12 年内评估的体重、腰围和体脂；以及产后 3 年内评估的血压。我们使用线性混合效应模型，根据年龄、种族/民族、收入、教育、婚姻状况、生育次数和初潮年龄进行调整。
342 名女性（21.6%）有不孕史。在调整后的模型中，与无不孕史的女性相比，有不孕史的女性平均体重（3.29 公斤，95%置信区间 [CI]：1.35-5.24）、腰围（2.46 厘米，95% CI：0.78-4.13）和体脂（1.76 公斤，95% CI：0.09-3.43）更高。在较年轻（18-29 岁）的女性中，但在较年长（≥30 岁）的女性中，不孕与更高的收缩压（4.08 毫米汞柱，95% CI：0.93，7.23）和舒张压（2.16 毫米汞柱，95% CI：0.11-4.20）相关。
不孕史可能是识别心血管代谢风险较高的女性的一个标志物。
