Childbearing, Child-Rearing, Cardiovascular Risk Factors, and Progression of Carotid Intima-Media Thickness

Abstract

Background and Purpose-Parity is associated with the risk of clinical cardiovascular events and the severity of preclinical atherosclerosis in older subjects. We sought to determine whether childbearing is associated with concurrent changes in cardiovascular risk factors and the progression of carotid intima-media thickness. Methods-We examined the association between the number of children born during a 6-year period and concurrent changes in cardiovascular risk factors and progression of carotid intima-media thickness in men and women of reproductive age from the Cardiovascular Risk in Young Finns study. Complete data for parity and carotid intima-media thickness were available for 1786 subjects (1005 females, 781 males). Results-For females, childbirth during the 6-year follow-up was associated with concurrent reductions in high-density lipoprotein cholesterol (P trend Ͻ0.0001), apolipoprotein A-I (P trend Ͻ0.0001), and apolipoprotein B (P trend ϭ0.01); a redistribution of adiposity to abdominal deposits; and increased progression of carotid intima-media thickness (7.5Ϯ3.2 m/birth Pϭ0.02). The association of childbirth with carotid intima-media thickness progression was not greatly modified by adjustment for concurrent changes in cardiovascular risk factors (fully adjusted: Pϭ0.05). This association was significantly stronger in females than males (P heterogeneity ϭ0.001), who served as a control group exposed to the social and lifestyle influences of child-rearing but not the biological influences of childbearing. Conclusions-The progression of carotid atherosclerosis over a 6-year period is increased in females who gave birth during the same period, independent of traditional risk factors. Mechanisms that underlie this observation possibly include parity-induced changes in nontraditional risk factors or an acute influence of pregnancy itself.

Vascular Dysfunction in Women with Recurrent Pregnancy Loss

“…It is suggested that the association between childbirth and concurrent changes in IMT may be independent of traditional cardiovascular risk factors (Skilton et al, 2010). However, another study described no association between parity and either IMT or presence of plaques after adjustment for age in a population based cohort of 746 Finnish women (Kharazmi et al, 2007).…”

“…However, comparisons between men and women distinguish whether the mechanisms for the association between parity and atherosclerosis involve biological processes related to pregnancy or socioeconomic or lifestyle factors that are related to family size and child-rearing. It has been reported that increasing parity is associated with carotid atherosclerosis in women but not in men among a population with at least one risk factor for cardiovascular disease (Lawlor et al, 2003;Skilton et al, 2009;Skilton et al, 2010).…”

Correlates of Cardiovascular Disease Risk Scores in Women in Riyadh, Kingdom of Saudi Arabia

“…The results of our study support these findings, and women should be counseled regarding weight reduction soon after delivery. A study by Skilton et al reported that child bearing augments the atherosclerosis process, thus increasing the risk of CVD [Skilton MR, et al, 2010]. The association between the number of children a woman has and CVD risk can also be explained on the basis of an increase in daily stressors, hassles and financial constraints because of a large family [WHO 2011].…”

“…Some studies have found that people of lower socioeconomic status suffer from the maximum number of CVD risk factors [Capingana DP, et al, 2013;Power C, et al, 2008], whereas others have found no A c c e p t e d M a n u s c r i p t 4 significant association between socioeconomic status and CVD risk factors [Lipowicz A, et al, 2007]. Similarly, some studies have found lifestyle factors to be related to CVD [Hardy R, et al, 2007;Jacobsen BK, et al, 2011], and Skilton et al [Skilton MR, et al, 2010] found increased atherosclerotic changes in carotid intima medial thickness, a subclinical indicator of CVD, to be associated with child-bearing in Australian women.…”

Stroke in Women - Oral Contraception, Pregnancy, and Hormone Replacement Therapy

“…Pregnancy might give a rapid progression to atherosclerosis. Skilton et al studied the relationship between parity and carotid atherosclerosis during a 6-year follow-up in a Finnish sample of Cardiovascular Risk in Young Finns Study [134]. They included 1786 subjects, 1005 females and 781 male controls.…”