NUMBER OF PREGNANCIES AND THE SUBSEQUENT RISK OF CARDIOVASCULAR-DISEASE
NUMBER OF PREGNANCIES AND THE SUBSEQUENT RISK OF CARDIOVASCULAR-DISEASE
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DOI：
10.1056/nejm199305273282104
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发表时间：
1993-05-27
影响因子：
158.5
通讯作者：
DAGOSTINO, RB
中科院分区：
文献类型：
--
作者：
NESS, RB;HARRIS, T;DAGOSTINO, RB
背景增加产次或妊娠是否是冠状动脉的危险因素。我们在两组已完成生育的妇女中检验了怀孕次数与各种心血管终点之间的关系。其中一组包括2357名女性，她们通过心脏研究随访了28年，另一组包括2533名女性，她们通过第一次全国健康和营养检查调查全国流行病学随访研究（NHEFS）随访了至少12年。在Fracheart研究和NHEFS中，多次妊娠妇女的冠心病发病率高于从未怀孕的妇女，但在这两项研究中，只有六次或六次以上妊娠的妇女的发病率较高。对于Fragmentary研究中的妇女，在六次或六次以上怀孕的妇女中（与从未怀孕的妇女相比），经年龄和教育水平调整的比率为1.6（95%置信区间，1.1至2.2）。对于NHEFS中的女性，相同的调整率比为1.5（95%置信区间为1.1至1.9）。调整其他已知的心血管危险因素，包括体重，并没有显着改变这种风险。在Frachial Study中，多次妊娠妇女的总心血管疾病发生率也显著高于从未妊娠的妇女。在美国的两项前瞻性研究中，怀孕六次或六次以上与冠心病和心血管疾病风险的小幅但一致的增加有关。我们观察到的风险增加是否是妊娠本身或其他一些不可测量的因素造成的，还需要进一步调查。
Background. Whether increasing parity or gravidity is a risk factor for coronaMethods. 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.