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The association of reproductive history with all-cause and cardiovascular mortality in older women: the Rancho Bernardo Study.
Fertil Steril 2012; 97(1):118-24FS

Abstract

OBJECTIVE

To examine associations of gravidity and parity with all-cause, cardiovascular disease (CVD), and coronary heart disease (CHD) mortality in postmenopausal women.

DESIGN

Prospective cohort study.

SETTING

Rancho Bernardo, a southern California community.

PATIENT(S)

One thousand two hundred ninety-four postmenopausal women ages 50-96 who attended a 1984-87 research clinic visit at which reproductive and medical histories were obtained and who were followed through 2007.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

All-cause, CVD, CHD, and non-CHD CVD mortality, determined by nosologist-coded death certificates.

RESULT(S)

Average baseline age was 70.6 ± 9.2. Numbers of pregnancies ranged from 0 to 13 (median = 2); births ranged from 0 to 11 (median = 2). During a median of 19.3 years of 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 and non-CHD CVD mortality. Women with four or more pregnancies were less likely than nulligravidas to have fatal CVD (hazard ratio [HR] = 0.63, 95% confidence interval [CI] = 0.40-0.99) and non-CHD CVD (HR = 0.48, 95% CI = 0.26-0.91) independent of age, years postmenopause, obesity, and HDL. Associations increased after the first decade of follow-up. Parity and gravidity were not associated with overall or CHD mortality.

CONCLUSION(S)

High gravidity was associated with reduced CVD and non-CHD CVD mortality in postmenopausal women. Protective associations could reflect biological mechanisms that occur with repeated pregnancy or greater social support related to family size among multiparous women.

Authors+Show Affiliations

Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, California 92093-0607, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22130321

Citation

Jacobs, Marni B., et al. "The Association of Reproductive History With All-cause and Cardiovascular Mortality in Older Women: the Rancho Bernardo Study." Fertility and Sterility, vol. 97, no. 1, 2012, pp. 118-24.
Jacobs MB, Kritz-Silverstein D, Wingard DL, et al. The association of reproductive history with all-cause and cardiovascular mortality in older women: the Rancho Bernardo Study. Fertil Steril. 2012;97(1):118-24.
Jacobs, M. B., Kritz-Silverstein, D., Wingard, D. L., & Barrett-Connor, E. (2012). The association of reproductive history with all-cause and cardiovascular mortality in older women: the Rancho Bernardo Study. Fertility and Sterility, 97(1), pp. 118-24. doi:10.1016/j.fertnstert.2011.10.028.
Jacobs MB, et al. The Association of Reproductive History With All-cause and Cardiovascular Mortality in Older Women: the Rancho Bernardo Study. Fertil Steril. 2012;97(1):118-24. PubMed PMID: 22130321.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association of reproductive history with all-cause and cardiovascular mortality in older women: the Rancho Bernardo Study. AU - Jacobs,Marni B, AU - Kritz-Silverstein,Donna, AU - Wingard,Deborah L, AU - Barrett-Connor,Elizabeth, Y1 - 2011/11/28/ PY - 2011/08/30/received PY - 2011/10/10/revised PY - 2011/10/24/accepted PY - 2011/12/2/entrez PY - 2011/12/2/pubmed PY - 2012/2/18/medline SP - 118 EP - 24 JF - Fertility and sterility JO - Fertil. Steril. VL - 97 IS - 1 N2 - OBJECTIVE: To examine associations of gravidity and parity with all-cause, cardiovascular disease (CVD), and coronary heart disease (CHD) mortality in postmenopausal women. DESIGN: Prospective cohort study. SETTING: Rancho Bernardo, a southern California community. PATIENT(S): One thousand two hundred ninety-four postmenopausal women ages 50-96 who attended a 1984-87 research clinic visit at which reproductive and medical histories were obtained and who were followed through 2007. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): All-cause, CVD, CHD, and non-CHD CVD mortality, determined by nosologist-coded death certificates. RESULT(S): Average baseline age was 70.6 ± 9.2. Numbers of pregnancies ranged from 0 to 13 (median = 2); births ranged from 0 to 11 (median = 2). During a median of 19.3 years of 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 and non-CHD CVD mortality. Women with four or more pregnancies were less likely than nulligravidas to have fatal CVD (hazard ratio [HR] = 0.63, 95% confidence interval [CI] = 0.40-0.99) and non-CHD CVD (HR = 0.48, 95% CI = 0.26-0.91) independent of age, years postmenopause, obesity, and HDL. Associations increased after the first decade of follow-up. Parity and gravidity were not associated with overall or CHD mortality. CONCLUSION(S): High gravidity was associated with reduced CVD and non-CHD CVD mortality in postmenopausal women. Protective associations could reflect biological mechanisms that occur with repeated pregnancy or greater social support related to family size among multiparous women. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/22130321/The_association_of_reproductive_history_with_all_cause_and_cardiovascular_mortality_in_older_women:_the_Rancho_Bernardo_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(11)02713-0 DB - PRIME DP - Unbound Medicine ER -