Reproductive factors and risk of cardiovascular diseases and all-cause and cardiovascular mortality in American women: NHANES 2003–2018

Abstract

Abstract Background The evidence regarding the association of reproductive factors with cardiovascular diseases (CVDs) is limited. Aims To investigate the relationship of reproductive factors with the risk of CVDs, as well as all-cause and cardiovascular mortality. Methods This study included 16,404 adults with reproductive factors from the National Health and Nutrition Examination Survey (NHANES) and followed up until 31 December 2019. Logistic models and restricted cubic spline models were used to assess the association of reproductive factors with CVDs. COX proportional hazards models and restricted cubic spline models, with adjustment for potential confounding, were employed to analyze the relation between reproductive factors and cardiovascular and all-cause death. Results There is a nonlinear relationship between age at menarche and CVDs. Age at menopause ≤ 11(OR 1.36, 95% CI 1.10–1.69) was associated with an increased risk of CVDs compared to ages 12–13 years. Age at Menopause ≤ 44 (OR 1.69, 95% CI 1.40–2.03) was associated with increased CVDs compared to age 35–49 years. Number of pregnancies ≥ 5(OR 1.26, 95% CI 1.02–1.55) was associated with an increased risk of CVDs compared to one pregnancy. In continuous variable COX regression models, a later age at menopause (HR 0.98, 95% CI 0.97–0.99) and a longer reproductive lifespan (HR 0.98, 95% CI 0.97–0.99) were associated with a decreased risk of all-cause death. A later age at menopause (HR 0.98, 95% CI 0.97–0.99) and a longer reproductive lifespan (HR 0.98, 95% CI 0.97–0.99) were associated with a decreased risk of cardiac death. Conclusions Female reproductive factors are significant risk factors for CVDs American women.