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ObjectivePrevious studies show that multiparity and a number of chronic conditions are correlated among women. Also, low respiratory muscle strength has been associated to adverse health outcomes such as chronic lung disease and early mortality. This study aimed to investigate associations between the number of lifetime pregnancies and maximal inspiratory/expiratory pressures.MethodsIn a cross-sectional study, 204 women ages 41–80 years-old, from the rural community of Santa Cruz, Brazil, provided data regarding demographics, socioeconomic characteristics, health behaviors, and number of lifetime pregnancies (≤3, 4–6 or ≥7). Maximal respiratory pressures were measured with a digital manometer. Multiple linear regression analysis was used to examine the association of multiple childbearing on maximal respiratory pressures.ResultsOf the participants, 44.1% had ≤3 pregnancies, 30.4% had 4–6 pregnancies and 25.5% had >7 pregnancies. In the unadjusted analyses, maximal inspiratory and expiratory pressures varied significantly according to multiple childbearing categories. After adjustment, the values remained statistically significant only for maximal expiratory pressure. Compared to women with ≤3 lifetime pregnancies, those who had ≥7 pregnancies had significantly lower maximal expiratory pressure values (β = -18.07, p = 0.01)ConclusionMultiple childbearing appears to be negatively associated with maximal respiratory pressures; women with a higher number of lifetime pregnancies had lower values of maximal respiratory pressures when compared to those with fewer pregnancies. This association may be due to biomechanical changes in the respiratory muscles promoted by multiple lifetime pregnancies. This finding indicates a need to motivate women, from the prenatal to postpartum period, to safely exercise their respiratory muscles, including abdominal muscle exercises as well as respiratory muscle training.

BACKGROUND: Neuromuscular diseases (NMDs) lead to different weakness patterns, and most patients with NMDs develop respiratory failure. Inspiratory and expiratory muscle strength can be measured by maximum static inspiratory pressure (P Imax ) and maximum static expiratory pressure (P Emax ), and the relationship between them has not been well described in healthy subjects and subjects with NMDs. Our aim was to assess expiratory/inspiratory muscle strength in NMDs and healthy subjects and calculate P Emax /P Imax ratio for these groups. METHODS: Seventy (35 males) subjects with NMDs (amyotrophic lateral sclerosis, myasthenia gravis, and myotonic dystrophy), and 93 (47 males) healthy individuals 20 -80 y of age were evaluated for anthropometry, pulmonary function, P Imax , and P Emax , respectively. RESULTS: Healthy individuals showed greater values for P Imax and P Emax when compared with subjects with NMDs. P Emax /P Imax ratio for healthy subjects was 1.31 ؎ 0.26, and P Emax %/P Imax % was 1.04 ؎ 0.05; for subjects with NMDs, P Emax /P Imax ratio was 1.45 ؎ 0.65, and P Emax %/P Imax % ratio was 1.42 ؎ 0.67. We found that P Emax %/P Imax % for myotonic dystrophy was 0.93 ؎ 0.24, for myasthenia gravis 1.94 ؎ 0.6, and for amyotrophic lateral sclerosis 1.33 ؎ 0.62 when we analyzed them separately. All healthy individuals showed higher P Emax compared with P Imax . For subjects with NMDs, the impairment of P Emax and P Imax is different among the 3 pathologies studied (P < .001). CONCLUSIONS: Healthy individuals and subjects with NMDs showed higher P Emax in comparison to P Imax regarding the P Emax /P Imax ratio. Based on the ratio, it is possible to state that NMDs show different patterns of respiratory muscle strength loss. P Emax /P Imax ratio is a useful parameter to assess the impairment of respiratory muscles in a patient and to customize rehabilitation and treatment.

Background: The measurement of nasal inspiratory pressure, known as the sniff test, was developed as a new test of inspiratory muscle strength,