Parity and carotid artery atherosclerosis in elderly women - The RotterdamStudy

Background and Purpose-It has been postulated that physiological changes in the cardiovascular system, lipids, and glucose metabolism during pregnancy may increase subsequent risk of cardiovascular disease. Examination of the association between parity and risk factors for atherosclerosis may contri bute information regarding possible mechanisms. Methods-The relationship of parity with cardiovascular risk factors and the presence of carotid atherosclerosis was examined in the Rotterdam Study, a population-based study comprising 4878 women aged 55 years and older. Caro tid atherosclerosis was assessed by ultrasonographic detection of plaques i n the common carotid artery and bifurcation. Logistic regression models wer e used to compute odds ratios and 95% confidence intervals, adjusted for co nfounding factors. Results-Parity was inversely associated with high-density lipoprotein chole sterol, and alcohol intake. Parity was positively associated with body mass index, total/HDL cholesterol ratio, insulin resistance, age at menopause, and socioeconomic status. Relative to nulliparous women, parous women had 3 6% (9% to 71%) greater risk of carotid atherosclerosis, rising to 64% in wo men with greater than or equal to4 children (19% to 127%). Adjustment for k nown cardiovascular risk factors, including insulin resistance and current lipid levels, did not diminish the magnitude of this association. Conclusions-Data demonstrated that there is a positive association between parity and risk of carotid artery plaques in elderly women and, further, th at high parity is associated with lower HDL cholesterol levels and higher g lucose/insulin ratios long after childbearing has ceased.