Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China.
Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China.
J Womens Health (Larchmt). 2024 Aug;33(8):1025-1033. doi: 10.1089/jwh.2023.0859. Epub 2024 Apr 12.
Atherosclerotic cardiovascular disease (ASCVD) remains the most common cause of death in women. Pregnancy is an exposure unique to women leading to significant changes in maternal cardiovascular function. However, studies of the relationship between the number of pregnancies and ASCVD are rare. We aimed to clarify the association between the number of pregnancies and ASCVD. In this cross-sectional study, we used publicly available data from the National Health and Nutrition Examination Survey from 1999 to 2018. The number of pregnancies was divided into 0 (reference), 1, 2-3, 4-5, or ≥6, to create more stable estimates. A multiple logistic regression approach was used to examine the correlation between pregnancy and ASCVD in women aged 45 years or older who reported no menstruation in the past 12 months due to menopause, as well as in those aged 55 years or older, encompassing various age groups. We also separately estimated the association between the exposure of pregnancy and individual components of ASCVD. In this study, age-adjusted data showed that women with six or more pregnancies had a doubled risk (odds ratio [OR]: 2.07) of ASCVD. The risk remained elevated at 1.69 times in women with four to five pregnancies and further increased to 1.90 times in women with six or more pregnancies, after adjusting for social factors. Similar patterns were observed when considering reproductive health and cardiovascular risk factors. Across the full population, every model that accounted for these variables consistently indicated that with an increasing number of pregnancies, we observed higher ORs for ASCVD risk (all values <0.05). A higher number of pregnancies was associated with a higher risk of ASCVD after menopause, especially among women aged 45-64 years. Moreover, this association is particularly significant in the risk of stroke, cardiovascular heart disease, and heart attack.
动脉粥样硬化性心血管疾病（ASCVD）仍然是女性死亡的最常见原因。怀孕是女性特有的一种暴露因素，会导致母体心血管功能发生重大变化。然而，关于妊娠次数与 ASCVD 之间关系的研究很少。我们旨在阐明妊娠次数与 ASCVD 之间的关系。
在这项横断面研究中，我们使用了 1999 年至 2018 年全国健康和营养调查中公开可用的数据。将妊娠次数分为 0（参考）、1、2-3、4-5 或≥6，以得出更稳定的估计。采用多变量逻辑回归方法，检查过去 12 个月因绝经而无月经且年龄在 45 岁或以上的女性以及年龄在 55 岁或以上的女性中，妊娠与 ASCVD 之间的相关性。我们还分别估计了妊娠暴露与 ASCVD 各个组成部分之间的关联。
在这项研究中，年龄调整数据显示，有 6 次或更多次妊娠的女性发生 ASCVD 的风险增加一倍（比值比[OR]：2.07）。在调整了社会因素后，有 4-5 次妊娠的女性风险仍处于高位，为 1.69 倍，有 6 次或更多次妊娠的女性风险进一步增加至 1.90 倍。在考虑生殖健康和心血管危险因素时，也观察到了类似的模式。在整个人群中，考虑到这些变量的所有模型都一致表明，随着妊娠次数的增加，ASCVD 风险的 OR 越高（所有 值<0.05）。
绝经后，妊娠次数越多，ASCVD 风险越高，尤其是 45-64 岁的女性。此外，这种关联在中风、心血管心脏病和心脏病发作的风险中尤为显著。
