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Childhood cardiovascular health and subfertility: the Bogalusa Heart Study
Yiping Wang1, Xu Xiong1, Lydia Bazzano1
1Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
Insights
Childhood cardiovascular risks like high LDL and total cholesterol, and pre-pregnancy risks like high blood pressure and glucose, are linked to adult female infertility. These associations persist even when excluding women with polycystic ovarian syndrome (PCOS).
Area of Science:
- Cardiovascular Health
- Reproductive Health
- Public Health
Background:
- Childhood cardiovascular risk factors are known contributors to adult cardiovascular disease.
- Adult cardiovascular health is intrinsically linked to reproductive health and fertility.
- The specific association between early-life cardiovascular risk and female infertility remains understudied.
Purpose of the Study:
- To investigate the association between early-life cardiovascular risk factors and female infertility.
- To determine if childhood cardiovascular risk factors predict fertility difficulties in adulthood.
- To examine the role of pre-pregnancy cardiovascular risk factors in female infertility.
Main Methods:
- The study analyzed data from 1799 women in the Babies substudy of the Bogalusa Heart Study.
- Cardiovascular risk factors including blood pressure, lipids, glucose, and insulin were assessed.
- Fertility difficulties were self-reported, and multivariable logistic regression was used to identify predictors, adjusting for confounders and polycystic ovarian syndrome (PCOS).
Main Results:
- Women with a history of PCOS reported higher rates of fertility difficulties.
- Childhood LDL and total cholesterol were elevated in women who never became pregnant.
- Pre-pregnancy systolic blood pressure and glucose levels were associated with increased risks of infertility indicators, independent of PCOS status.
Conclusions:
- Certain childhood cardiovascular risk factors, such as elevated LDL and total cholesterol, are associated with female infertility.
- Pre-pregnancy cardiovascular risk factors, including elevated systolic blood pressure and glucose, are linked to subfertility.
- These findings highlight the importance of early cardiovascular health in reproductive well-being.
Background:
Although childhood cardiovascular risk can contribute to adult cardiovascular disease, and fertility and adult cardiovascular health are linked, the association between early-life cardiovascular risk and female infertility has not been studied.
Methods:
A total of 1799 women participated in the Babies substudy of the Bogalusa Heart Study. Systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, glucose, and insulin were age-standardized and examined as predictors of self-reported fertility difficulties using multivariable logistic regression with adjustment for confounders. Polycystic ovarian syndrome (PCOS) was assessed via a report of diagnosis and symptoms, using a validated questionnaire.
Results:
Women with a history of PCOS were more likely to report fertility difficulties. Childhood and adolescent cardiovascular risk factors were generally not associated with fertility indicators, although childhood LDL (aOR 1.38 per one-SD increase, 0.97-1.96) and total cholesterol (aOR 1.49, 1.06-2.11) were raised in those who never became pregnant. Pre-pregnancy risk SBP (overall fertility, aOR 1.49, 1.00-2.23) and glucose levels (ever tried but unable, aOR 2.65, 1.39-5.06) were associated with an increased risk of some infertility indicators. These results were largely unaffected by exclusion of women with PCOS.
Conclusion:
Some childhood and pre-pregnancy cardiovascular risk factors are associated with adult subfertility.
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