Flow mediated vasodilation and circulating concentrations of high sensitive C‐reactive protein, interleukin‐6 and tumor necrosis factor‐α in normal pregnancy – The Cardiovascular Risk in Young Finns Study

Saarelainen, Heli; Valtonen, Pirjo; Punnonen, Kari; Laitinen, Tomi; Raitakari, Olli T.; Juonala, Markus; Heiskanen, Nonna; Lyyra-Laitinen, Tiina; Viikari, Jorma; Heinonen, Seppo

doi:10.1111/j.1475-097x.2009.00877.x

Cited by 21 publications

(19 citation statements)

References 26 publications

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“…Previous studies also show enhanced endothelial function during pregnancy despite concurrent hyperlipidemia and metabolic changes (25), an effect which may carry over postpartum. Endothelial dysfunction is a hallmark of vascular diseases and hypertension, and is predictive of future cardiovascular events (26).…”

Section: Discussionmentioning

confidence: 87%

The association of reproductive history with all-cause and cardiovascular mortality in older women: the Rancho Bernardo Study

Jacobs

Kritz‐Silverstein

Wingard

et al. 2012

Fertility and Sterility

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Objective To examine associations of gravidity and parity with all-cause, CVD and CHD mortality in postmenopausal women. Design Prospective cohort study. Setting Rancho Bernardo, a southern California community. Patients 1,294 postmenopausal women aged 50–96 who attended a 1984–87 research clinic visit when reproductive and medical histories were obtained, and were followed through 2007. Interventions None. Main Outcome Measures All-cause, CVD, CHD, and non-CHD CVD mortality, determined by nosologist-coded death certificates. Results Average baseline age was 70.6±9.2. Numbers of pregnancies ranged from 0–13 (median=2); births ranged from 0–11 (median=2). During a median of 19.3 years follow-up, 707 women (54.6%) died with 46.5% attributed to CVD, 20.5% to CHD, and 26.0% to non-CHD CVD. Trend analyses showed inverse associations of gravidity with CVD mortality (p=0.05) and non-CHD CVD mortality (p=0.05). Women with ≥4 pregnancies were less likely than nulligravid to have fatal CVD (HR=0.63, 95% CI=0.40–0.99) and non-CHD CVD (HR=0.48, 95% CI=0.26–0.91) independent of age, years post-menopause, obesity, and HDL. Associations increased after the first decade of follow-up. Parity and gravidity were not associated with overall or CHD mortality. Conclusions High gravidity was associated with reduced CVD and non-CHD CVD mortality in postmenopausal women. Protective associations could reflect biological mechanisms occurring with repeated pregnancy or greater social support related to family size among multiparous women.

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Section: Discussionmentioning

confidence: 87%

The association of reproductive history with all-cause and cardiovascular mortality in older women: the Rancho Bernardo Study

Jacobs

Kritz‐Silverstein

Wingard

et al. 2012

Fertility and Sterility

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“…Potential mechanisms underlying a direct biological effect of pregnancy on atherosclerosis may include the transient hemodilution of pregnancy or increases of lipids, insulin resistance, oxidative stress, sex steroids, and inflammation during pregnancy. 7,8 In contrast, endothelial function is improved and asymmetrical dimethylarginine decreased during pregnancy, both of which would be expected to slow the progression of atherosclerosis. 8,25 Childbearing or Child-Rearing: Insights Derived From Males…”

Section: Childbirth and Cimt Progression: Other Potential Mechanismsmentioning

confidence: 99%

“…7,8 In contrast, endothelial function is improved and asymmetrical dimethylarginine decreased during pregnancy, both of which would be expected to slow the progression of atherosclerosis. 8,25 Childbearing or Child-Rearing: Insights Derived From Males…”

Section: Childbirth and Cimt Progression: Other Potential Mechanismsmentioning

confidence: 99%

“…This may be driven by perigestational factors such as acute elevations in lipids, insulin resistance, oxidative stress, and inflammation or may be related to the changes in sex steroids or hemodilution. 7,8 To study whether pregnancy is associated with the progression of atherosclerosis, we examined the association between the number of children born during a 6-year period and the concurrent progression of carotid intima-media thickness (cIMT) in women of a reproductive age from the Cardiovascular Risk in Young Finns study. We also studied males from the same cohort as a control group exposed to child-rearing but not childbearing, allowing us to differentiate the effects of changes in risk behaviors and lifestyle factors that accompany child-rearing from the biological influences of childbearing.…”

mentioning

confidence: 99%

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

Skilton

Bonnet

Begg

et al. 2010

Stroke

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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.

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“…An early study reported a progressive increase in CRP across the weeks of gestation (Romem and Artal 1985). Others have reported that CRP is already high in early pregnancy (Sacks et al, 2004), remains elevated at a similar level into later pregnancy (Belo et al, 2005; Picklesimer et al, 2008), or that CRP peaks in mid-pregnancy (Saarelainen et al, 2009). Although at least one study reported ethnic differences in pregnancy CRP (Picklesimer et al, 2008), little is known about the extent of human variation in the magnitude or timecourse of inflammatory changes during pregnancy.…”

mentioning

confidence: 99%

C‐reactive protein by pregnancy and lactational status among Filipino young adult women

Kuzawa

Adair

Borja

et al. 2012

American J Hum Biol

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Objectives Pregnancy and lactation involve adaptations in immune regulation, but little is known about cross-cultural variation in inflammatory changes during pregnancy or lactation. Here we report concentrations of C-reactive protein (CRP) in a large cross-sectional sample of healthy Filipino women who vary in parity, gestational and lactational status, and who come from a population previously described as having low CRP. Methods Fasting plasma CRP was measured among female participants (ages 20.8-22.4 years) in the Cebu Longitudinal Health and Nutrition Survey (n=822). Results Median CRP was 0.2 mg/L in nulliparous women and peaked at 2.0 mg/L in women in their 3rd trimester of pregnancy. Parous but post-partum women had higher CRP compared to nulliparous women, which was largely explained by body composition differences as reflected in waist circumference and skinfold measures. Among post-partum women with infants, CRP was similar in women who were currently breastfeeding compared to those who were not. Conclusions At Cebu, women late in gestation have 10-fold higher C-reactive protein compared to nulliparous women, with no evidence that lactation is inflammatory. These population-based findings are similar with findings from prior clinic-based studies and are consistent with the maternal immunological adaptations initiated during pregnancy. The tendency of human females to spend more time than females of other great apes in gestation rather than lactation suggests that the human life history strategy involved increased time spent by reproductively aged females in a pro-inflammatory state.

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Flow mediated vasodilation and circulating concentrations of high sensitive C‐reactive protein, interleukin‐6 and tumor necrosis factor‐α in normal pregnancy – The Cardiovascular Risk in Young Finns Study

Abstract: Improvement of FMD in normal pregnancy was not affected by increase in hsCRP concentration. We found an association with IL-6 and FMD but we believe that improvement in endothelial function during normal pregnancy is not caused by variation in hsCRP, IL-6 or TNF-alpha.

Cited by 21 publications

References 26 publications

The association of reproductive history with all-cause and cardiovascular mortality in older women: the Rancho Bernardo Study

The association of reproductive history with all-cause and cardiovascular mortality in older women: the Rancho Bernardo Study

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

C‐reactive protein by pregnancy and lactational status among Filipino young adult women

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