Live birth/parity number and the risk of incident hypertension among parous women during over 13 years of follow-up

Abstract

The effect of live birth/parity number on incident hypertension was investigated among Iranian parous women aged 30-70 years. The study population included 2188 normotensive women who were enrolled in 1999-2001. They were followed for incident hypertension (based on JNC 7 report) by 3-year intervals up to April 2018. Multivariable Cox proportional hazard models, adjusted for a wide set of potential hypertension risk factors, reproductive factors, and pregnancy complications, were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the number of parity/live birth(s) for incident hypertension. Additionally, as a sensitivity analysis, age-scale Cox regression was also done. During a median follow-up of 13.5 years, 935 incident hypertension have occurred. Compared to those with two live births, the participants who had 3 and ≥4 live births were at higher risk of hypertension development by the HRs of 1.25 [95% CI: 1.02-1.55] and 1.39 [1.12-1.72], respectively, in the full-adjusted model. Moreover, each additional live birth increased the risk of hypertension by a HR of 1.06 [95%CI: 1.02-1.11]. Results of parity number were also similar. Considering age as time scale also did not change the results generally. The authors found a significant interaction between live birth/parity number and age groups; the adverse effect of higher live birth/parity numbers on hypertension development was mainly found among those aged < 50 years. To sum up, compared to the live birth/parity number of two, Iranian women with ≥3 live birth/parity had a higher risk of incident hypertension; the issue was more prominent among younger mothers.

Keywords: Tehran Lipid and Glucose Study; incident hypertension; live birth; parity.

FIGURE 1

Timeline chart for participants who developed hypertension during follow‐up (n = 935): Tehran Lipid and Glucose Study, Iran, 1999–2018

FIGURE 2

Multivariable hazard ratios (HR) and 95% confidence intervals (CI) of incident hypertension by live birth/parity number in different age‐groups: Tehran Lipid and Glucose Study, Iran, 1999–2018