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Previous Volume 328:1528-1533 May 27, 1993 Number 21 Next

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ABSTRACT

Background Whether increasing parity or gravidity is a risk factor for coronary heart disease has been debated, but the question remains unresolved.

Methods We tested the association between the number of pregnancies and a variety of cardiovascular end points in two groups of women who had completed childbearing. One group comprised 2357 women who were followed for 28 years through the Framingham Heart Study, and the other 2533 women followed for at least 12 years through the first National Health and Nutrition Examination Survey National Epidemiologic Follow-up Study (NHEFS).

Results The rates of coronary heart disease were higher among multigravid women than among women who had never been pregnant, in both the Framingham Heart Study and the NHEFS, but in both studies, the higher rates were statistically significant only in women with six or more pregnancies. For the women in the Framingham Study, the rate ratio adjusted for age and educational level in the group with six or more pregnancies (as compared with women who had never been pregnant) was 1.6 (95 percent confidence interval, 1.1 to 2.2). For the women in the NHEFS, the same adjusted rate ratio was 1.5 (95 percent confidence interval, 1.1 to 1.9). Adjustments for other known cardiovascular risk factors, including weight, did not markedly alter this risk. The rate of total cardiovascular disease was also significantly higher among multigravid women in the Framingham Study than in the women who had never been pregnant.

Conclusions In two prospective American studies, having six or more pregnancies was associated with a small but consistent increase in the risk of coronary heart disease and cardiovascular disease. Whether gravidity itself or some other unmeasured factor accounts for the increase in risk that we observed requires further investigation.

Source Information

From the Clinical Epidemiology Unit and the Emergency Department, Department of Medicine (R.B.N.), and the Department of Psychiatry (A.J.S.), University of Pennsylvania, Philadelphia; the National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md. (T.H., K.M.F.); the Department of Health Research and Policy, Stanford University, San Francisco (J.L.K.); and the Department of Mathematics, Statistics Unit, Boston University, Boston (J.C., A.B., R.B.D.).

Address reprint requests to Dr. Ness at the University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Rm. A527, Crabtree Hall, Pittsburgh, PA 15261.

Full Text of this Article

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Number of Pregnancies and Risk of Cardiovascular Disease
Grinblatt J. A., Dekker J. M., Schouten E. G., Palmer J. R., Rosenberg L., Shapiro S., Ness R. B., Harris T., Cobb J.
Extract | Full Text  
N Engl J Med 1993; 329:1893-1895, Dec 16, 1993. Correspondence

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