Bonner Alison N, Jayawickreme Shantal, Malek Angela M, Vladutiu Catherine J, Oliver-Williams Clare, Cortés Yamnia I, Tanaka Hirofumi, Meyer Michelle L
Medical Doctorate Program, University of North Carolina School of Medicine, Chapel Hill, NC, United States.
Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States.
Front Cardiovasc Med. 2023 May 23;10:1172828. doi: 10.3389/fcvm.2023.1172828. eCollection 2023.
Although studies have demonstrated a J-shaped association between parity and cardiovascular disease (CVD), the association with arterial stiffness is not fully understood.
We examined the association between parity and carotid-femoral pulse wave velocity (cfPWV), a measure of central arterial stiffness. We conducted a longitudinal analysis of 1220 women (mean age 73.7 years) who attended the Atherosclerosis Risk in Communities Study visit 5 (2011-2013). At visit 2 (1990-1992), women self-reported parity (number of prior live births), which we categorized as: 0 (never pregnant or pregnant with no live births); 1-2 (referent); 3-4; and 5+ live births. Technicians measured cfPWV at visit 5 (2011-2013) and visit 6 or 7 (2016-2019). Multivariable linear regression modeled the associations of parity with visit 5 cfPWV and cfPWV change between visit 5 and 6/7 adjusted for demographics and potential confounding factors.
Participants reported 0 (7.7%), 1-2 (38.7%), 3-4 (40.0%), or 5+ (13.6%) prior live births. In adjusted analyses, women with 5+ live births had a higher visit 5 cfPWV (=50.6 cm/s, 95% confidence interval: 3.6, 97.7 cm/s) than those with 1-2 live births. No statistically significant associations were observed for other parity groups with visit 5 cfPWV or with cfPWV change.
In later life, women with 5+ live births had higher arterial stiffness than those with 1-2 live births, but cfPWV change did not differ by parity, suggesting women with 5+ live births should be targeted for early primary prevention of CVD given their higher arterial stiffness at later-life.
尽管研究已证明生育次数与心血管疾病（CVD）之间呈J形关联，但生育次数与动脉僵硬度之间的关联尚未完全明确。
我们研究了生育次数与颈动脉 - 股动脉脉搏波速度（cfPWV，一种衡量中心动脉僵硬度的指标）之间的关联。我们对参加社区动脉粥样硬化风险研究第5次随访（2011 - 2013年）的1220名女性（平均年龄73.7岁）进行了纵向分析。在第2次随访（1990 - 1992年）时，女性自行报告生育次数（既往活产婴儿数量），我们将其分类为：0次（从未怀孕或怀孕但无活产）；1 - 2次（参照组）；3 - 4次；以及5次及以上活产。技术人员在第5次随访（2011 - 2013年）以及第6次或第7次随访（2016 - 2019年）时测量cfPWV。多变量线性回归模型分析了生育次数与第5次随访时的cfPWV以及第5次与第6/7次随访之间cfPWV变化的关联，并对人口统计学因素和潜在混杂因素进行了调整。
参与者报告的既往活产次数分别为0次（7.7%）、1 - 2次（38.7%）、3 - 4次（40.0%）或5次及以上（13.6%）。在调整分析中，生育5次及以上的女性在第5次随访时的cfPWV更高（=50.6 cm/s，95%置信区间：3.6，97.7 cm/s），高于生育1 - 2次的女性。未观察到其他生育次数组与第5次随访时的cfPWV或cfPWV变化之间存在统计学显著关联。
在晚年，生育5次及以上的女性比生育1 - 2次的女性具有更高的动脉僵硬度，但cfPWV变化并未因生育次数而异，这表明鉴于生育5次及以上的女性在晚年具有更高的动脉僵硬度，应将其作为心血管疾病早期一级预防的目标人群。
