This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Humphries, K. H. Articles by Witteman, J. C.M. Search for Related Content PubMed PubMed Citation Articles by Humphries, K. H. Articles by Witteman, J. C.M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Carotid Artery Disease Hazardous Substances DB CHOLESTEROL Related Collections Coronary imaging: angiography/ultrasound/Doppler/CC Risk Factors

(Stroke. 2001;32:2259.)
© 2001 American Heart Association, Inc.

Original Contributions

Parity and Carotid Artery Atherosclerosis in Elderly Women

The Rotterdam Study

Karin H. Humphries, DSc; Iris C.D. Westendorp, PhD; Michiel L. Bots, PhD; John J. Spinelli, PhD; Ronald G. Carere, MD; Albert Hofman, PhD Jacqueline C.M. Witteman, PhD

From the Centre for Health Evaluation and Outcome Sciences (K.H.H.), St Paul’s Hospital, the Department of Health Care and Epidemiology, University of British Columbia (J.J.S.), and the Division of Cardiology, St Paul’s Hospital and Department of Medicine, University of British Columbia (R.G.C.), Vancouver, Canada; and the Department of Epidemiology and Biostatistics, Erasmus Medical Centre Rotterdam (I.C.D.W., A.H., J.C.M.W.), Rotterdam, the Netherlands, and Julius Center for Patient Oriented Research, University Medical Center (M.L.B.), Utrecht, the Netherlands.

Correspondence to Jacqueline Witteman, PhD, Department of Epidemiology and Biostatistics, Erasmus Medical Centre Rotterdam, PO Box 1738, 3000 DR Rotterdam, Netherlands. E-mail witteman{at}epib.fgg.eur.nl

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 contribute 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. Carotid atherosclerosis was assessed by ultrasonographic detection of plaques in the common carotid artery and bifurcation. Logistic regression models were used to compute odds ratios and 95% confidence intervals, adjusted for confounding factors.

Results—— Parity was inversely associated with high-density lipoprotein cholesterol, 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 36% (9% to 71%) greater risk of carotid atherosclerosis, rising to 64% in women with 4 children (19% to 127%). Adjustment for known 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, that high parity is associated with lower HDL cholesterol levels and higher glucose/insulin ratios long after childbearing has ceased.

Key Words: atherosclerosis • cardiovascular diseases • lipids • parity • risk factors • women

This article has been cited by other articles:

				E. P. Gunderson, C. E. Lewis, A.-L. Tsai, V. Chiang, M. Carnethon, C. P. Quesenberry Jr., and S. Sidney A 20-Year Prospective Study of Childbearing and Incidence of Diabetes in Young Women, Controlling for Glycemia Before Conception: The Coronary Artery Risk Development in Young Adults (CARDIA) Study Diabetes, December 1, 2007; 56(12): 2990 - 2996. [Abstract] [Full Text] [PDF]

				S Dahaghin, S M A Bierma-Zeinstra, B W Koes, J M W Hazes, and H A P Pols Do metabolic factors add to the effect of overweight on hand osteoarthritis? The Rotterdam Study Ann Rheum Dis, July 1, 2007; 66(7): 916 - 920. [Abstract] [Full Text] [PDF]

				J. Blaauw, M. G. van Pampus, J. J. Van Doormaal, M. R. Fokkema, V. Fidler, A. J. Smit, and J. G. Aarnoudse Increased intima-media thickness after early-onset preeclampsia. Obstet. Gynecol., June 1, 2006; 107(6): 1345 - 1351. [Abstract] [Full Text] [PDF]

				M. Hinkula, A. Kauppila, S. Nayha, and E. Pukkala Cause-specific Mortality of Grand Multiparous Women in Finland Am. J. Epidemiol., February 15, 2006; 163(4): 367 - 373. [Abstract] [Full Text] [PDF]

				O. S. Descamps, M. Bruniaux, P.-F. Guilmot, R. Tonglet, and F. R. Heller Lipoprotein metabolism of pregnant women is associated with both their genetic polymorphisms and those of their newborn children J. Lipid Res., November 1, 2005; 46(11): 2405 - 2414. [Abstract] [Full Text] [PDF]

				V. Dhawan, Z. L. S. Brookes, and S. Kaufman Repeated pregnancies (multiparity) increases venous tone and reduces compliance Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2005; 289(1): R23 - R28. [Abstract] [Full Text] [PDF]

				B. Wolff, H. Volzke, D. Robinson, C. Schwahn, J. Ludemann, C. Kessler, U. John, and S. B. Felix Relation of Parity With Common Carotid Intima-Media Thickness Among Women of the Study of Health in Pomerania Stroke, May 1, 2005; 36(5): 938 - 943. [Abstract] [Full Text] [PDF]

				V. Dhawan, Z. L.S. Brookes, and S. Kaufman Long-term effects of repeated pregnancies (multiparity) on blood pressure regulation Cardiovasc Res, October 1, 2004; 64(1): 179 - 186. [Abstract] [Full Text] [PDF]

				S. Helle, V. Lummaa, and J. Jokela Accelerated immunosenescence in preindustrial twin mothers PNAS, August 17, 2004; 101(33): 12391 - 12396. [Abstract] [Full Text] [PDF]

				R. Hultgren, P. Olofsson, and E. Wahlberg Reproductive History in Women with Lower Limb Ischemia Angiology, July 1, 2004; 55(4): 373 - 383. [Abstract] [PDF]

				E. P. Gunderson, C. E. Lewis, M. A. Murtaugh, C. P. Quesenberry, D. Smith West, and S. Sidney Long-term Plasma Lipid Changes Associated with a First Birth: The Coronary Artery Risk Development in Young Adults Study Am. J. Epidemiol., June 1, 2004; 159(11): 1028 - 1039. [Abstract] [Full Text] [PDF]

				D. A. Lawlor, J. R. Emberson, S. Ebrahim, P. H. Whincup, S. G. Wannamethee, M. Walker, and G. D. Smith Is the Association Between Parity and Coronary Heart Disease Due to Biological Effects of Pregnancy or Adverse Lifestyle Risk Factors Associated With Child-Rearing?: Findings From the British Women's Heart and Health Study and the British Regional Heart Study Circulation, March 11, 2003; 107(9): 1260 - 1264. [Abstract] [Full Text] [PDF]