Associations of Pregnancy History and Complications with Cardiovascular Disease Among American Indian Women: The Strong Heart Family Study

Abstract

Introduction:

In the United States, cardiovascular disease (CVD) is a leading cause of death among American Indian women. We examined the associations of parity and pregnancy complications (history of preeclampsia, protein in urine, eclampsia or seizures, gestational diabetes, hypertension) with incident CVD (myocardial infarction, coronary heart disease, congestive heart failure, ischemic stroke) among American Indian women in the Strong Heart Family Study.

Methods:

Baseline information was collected between January 2006 and December 2009, and CVD events were evaluated through December 2022. We used clustered logistic regression analyses to assess associations of each parity or pregnancy complications with risk of CVD among women free of CVD at baseline (N = 1,203).

Results:

We found no statistically significant association of parity with risk of CVD when comparing grand multiparous (≥5) women (OR = 0.76, 95% CI: 0.39, 1.46; p = 0.41) and moderate parous (2–4) women (OR = 1.33; 95% CI: 0.65, 2.71; p = 0.44) to low parous (0/1) women. We found no statistically significant association of pregnancy complications with risk of CVD (OR = 1.08, 95% CI: 0.62, 1.88; p = 0.78) comparing participants with no pregnancy complications to those with pregnancy complications.

Conclusion:

Although not statistically significant, findings support potential positive associations of grand multiparity and pregnancy complications with CVD among American Indian women. Given the limited sample size, more research is needed to assess the impact of multiparity and/or pregnancy complications on CVD risk among American Indians women.