Parity and risk of maternal cardiovascular disease: A dose–response meta-analysis of cohort studies
Abstract
Background: Parity has been reported to play an important role in the development of cardiovascular disease; however, the results are still controversial. We aimed to conduct a meta-analysis of cohort studies to assess quantitatively the association between parity and cardiovascular disease risk. Methods: PubMed and Web of Science databases were searched to 1 June 2018, supplemented by manual searches of the bibliographies of retrieved articles. And multivariate-adjusted relative risks were pooled by using random-effects models. Restricted cubic spline analysis with four knots was used to explore the relationship of parity and the risk of cardiovascular disease. Results: Ten cohort studies involving 150,512 incident cases of cardiovascular disease among 3,089,929 participants were included in the meta-analysis. A significant association between parity and cardiovascular disease risk was observed while comparing parity with nulliparity, with a summarised relative risk of 1.14 (95% confidence interval (CI) 1.09–1.18; I 2 = 62.0%, P = 0.002). In the dose–response analysis, we observed a potential non-linear J-shaped dose–response relationship between the number of parity and cardiovascular disease risk, the summary risk estimates for an increase of one live birth was 1.04 (95% CI 1.02–1.05), with significant heterogeneity ( I 2 = 89.6%). In addition, the similar J-shaped associations between parturition number and cardiovascular disease, ischaemic heart disease or stroke risk were also observed. Conclusions: Our findings suggest that ever parity is related to cardiovascular disease risk and there is an association between the number of pregnancies and the risk of cardiovascular disease. Since the number of included studies was limited, further studies are warranted to confirm our findings.
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For non-fatal events, the risk of composite cardiovascular disease increases by 4% for each live birth.
“For non-fatal events,90 however, the risk of composite cardiovascular disease was increased in ever parous women, with the risk increasing by 4% for each live birth.90”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [90]
For non-fatal events, the risk of composite cardiovascular disease is increased in ever parous women.
“For non-fatal events,90 however, the risk of composite cardiovascular disease was increased in ever parous women, with the risk increasing by 4% for each live birth.90”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [90]
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- Authors
- Li, W., Ruan, W., Lu, Z., & Wang, D.
- Affiliations
- Huazhong University of Science and Technology (CN)
- Xi'an Medical University (CN)
- Corresponding author
- Wang, Dongming
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-12-19
- Volume
- 26
- Issue
- 6
- Pages
- 592-602
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- OpenAlex
- W2905347020
- Cited by
- 139
- References
- 44
- Citations by year
- 2026: 16 · 2025: 27 · 2024: 26 · 2023: 24 · 2022: 16 · 2021: 16 · 2020: 11 · 2019: 3
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Preventive Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- parity, maternal cardiovascular disease, ischemic heart disease, stroke, number of live births, nulliparity, J-shaped dose-response relationship
- MeSH terms
- Maternal Health, Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Humans, Middle Aged, Parity, Pregnancy, Risk Factors, Incidence, Risk Assessment, Observational Studies as Topic
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