Female reproductive history linked to risk for atherosclerotic CVD

October 21, 2021

2 min read

Source/Disclosures

Source:
Murugappan G, et al. Abstract O-34. Presented at: American Society of Reproductive Medicine Scientific Congress & Expo; Oct. 17-20, 2021; Baltimore (hybrid meeting).

Disclosures:
Healio could not confirm relevant financial disclosures at the time of publication.

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Infertility was independently associated with an increased risk for atherosclerotic CVD among nulliparous women, a longitudinal cohort study showed.

However, researchers found no significant association between infertility and atherosclerotic CVD (ASCVD) risk among parous women, “suggesting that parity may have a stronger cumulative effect on ASCVD risk than fertility status,” Gayathree Murugappan, MD, an instructor of obstetrics and gynecology at Stanford Hospital and Clinics, said during a presentation.

Reference: Murugappan G, et al. Abstract O-34. Presented at: American Society of Reproductive Medicine Scientific Congress & Expo.

“Infertility, despite affecting 10% to 15% of women, has been relatively understudied as a cardiovascular disease risk factor,” Murugappan told Healio. “Also, the influence of pregnancy, pregnancy loss and live birth on the association between infertility and risk of ASCVD has not been previously examined.”

Gayathree Murugappan

Murugappan and colleagues analyzed the reproductive history of 159,542 postmenopausal women who participated in the Women’s Heart Initiative. The women had an average age of 63 years at the time of study enrollment.

“Cardiovascular disease typically occurs in the 7th decade of life, and the [Women’s Heart Initiative] is unique because women were followed for 2 decades after enrollment,” Murugappan said. “Additionally, detailed reproductive history information was collected on all women at the time of enrollment, which makes the Women’s Heart Initiative a tremendous resource for women’s health research.”

Data gleaned from the analysis were adjusted for age at enrollment and menopause, family income, education, race and a diagnosis of high cholesterol or high BP during follow up, according to the researchers.

Overall, 5,491 of the 19,206 nulliparous women in the study and 20,561 of the 140,336 parous women had a history of infertility.

According to the results, presented at the American Society for Reproductive Medicine Scientific Congress & Expo, the prevalence of ASCVD was lowest among nulliparous women with no history of infertility at 12.8%. Meanwhile, ASCVD incidence was about 15% among nulliparous women who experienced infertility and all parous women, regardless of fertility status.

In a fully adjusted model, Murugappan and colleagues found a 13% increased risk for ASCVD among nulliparous women who experienced infertility (adjusted HR = 1.13; 95% CI, 1.04-1.23), but no significant association among parous women.

“Achieving live birth from a pregnancy may … be a sign of cardiovascular resilience that outweighs the relative contribution of fertility status,” Murugappan said in the interview.

“Conversely, the inability to achieve live birth may be an independent driver of atherosclerotic CVD risk.”

She said that additional studies are needed to confirm the associations and their “root causes.”

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American Society of Reproductive Medicine Scientific Congress & Expo

American Society of Reproductive Medicine Scientific Congress & Expo

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