Pregnancy and childbirth are associated with hemodynamic changes and vascular remodeling. It is not known whether parity is associated with later adverse vascular properties such as larger arterial diameter, wall thickness, and lower distensibility. We used baseline data from 3283 women free of cardiovascular disease aged 45 to 84 years enrolled in the population-based Multi-Ethnic Study of Atherosclerosis. Participants self-reported parity status. Ultrasound-derived carotid artery lumen diameters and brachial artery blood pressures were measured at peak-systole and end-diastole. Common carotid intima-media thickness was also measured. Regression models to determine the association of carotid distensibility coefficient, lumen diameter, and carotid intima-media thickness with parity were adjusted for age, race, height, weight, diabetes mellitus, current smoking, blood pressure medication use, and total and high-density lipoprotein cholesterol levels. The prevalence of nulliparity was 18%. In adjusted models, carotid distensibility coefficient was 0.09×10−5 Pa−1 lower (P=0.009) in parous versus nulliparous women. Among parous women, there was a nonlinear association with the greatest carotid distensibility coefficient seen in women with 2 live births and significantly lower distensibility seen in primiparas (P=0.04) or with higher parity >2 (P=0.005). No such pattern of association with parity was found for lumen diameter or carotid intima-media thickness. Parity is associated with lower carotid artery distensibility, suggesting arterial remodeling that lasts beyond childbirth. These long-term effects on the vasculature may explain the association of parity with cardiovascular events later in life.

译文

妊娠和分娩与血流动力学变化和血管重塑有关。尚不清楚奇偶性是否与后来的不利血管特性有关,例如较大的动脉直径,壁厚和较低的扩张性。我们使用了3283名年龄在45至84岁的无心血管疾病的女性的基线数据,这些女性参加了基于人群的多种族动脉粥样硬化研究。参与者自我报告的平价状态。在收缩期和舒张末期测量超声衍生的颈动脉管腔直径和肱动脉血压。还测量了颈总动脉内膜中层厚度。根据年龄,种族,身高,体重,糖尿病,当前吸烟,血压药物使用以及总和高密度脂蛋白胆固醇水平,调整了用于确定颈动脉扩张性系数,管腔直径和颈动脉内膜中层厚度与平价的关系的回归模型。nulliparity的患病率为18%。在校正模型中,产妇与未产妇相比,颈动脉扩张性系数低0.09 × 10-5 Pa-1 (P = 0.009)。在分娩妇女中,与2例活产妇女的最大颈动脉扩张系数和初产妇 (P = 0.04) 或较高胎次> 2 (P = 0.005) 的扩张系数存在非线性关联。对于管腔直径或颈动脉内膜中层厚度,未发现这种与奇偶性相关的模式。胎次与较低的颈动脉扩张性有关,表明动脉重塑持续到分娩后。这些对脉管系统的长期影响可能解释了胎次与以后生活中心血管事件的关联。

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