Recurrent births (multiparity) lead to permanent changes in cardiac structure

Area of Science:

• Cardiology
• Reproductive Medicine
• Medical Imaging

Background:

• Pregnancy induces significant cardiovascular adaptations.
• Permanent cardiac structural changes in multiparous women remain understudied.
• Transthoracic echocardiography (TTE) is a key imaging modality for cardiac assessment.

Purpose of the Study:

• To investigate permanent structural cardiac alterations in multiparous women.
• To compare cardiac parameters between women with multiple births and nulliparous controls.
• To identify potential links between parity and cardiac remodeling.

Main Methods:

• Case-control study involving 366 multiparous women and 218 nulliparous women.
• Comprehensive assessment including medical history, physical examination, ECG, TTE, and exercise stress tests.
• Detailed analysis of structural cardiac parameters using TTE.

Main Results:

• Women with ≥5 deliveries showed higher left ventricular (LV) mass, LV mass index, LV end-diastolic volume (LVEDV), and LVEDV index compared to nulliparous women.
• Ejection fraction (EF) was significantly lower in women with ≥5 deliveries.
• ROC analysis indicated high sensitivity (74%) and specificity (97.8%) for predicting eccentric hypertrophy in women with >10.5 births.

Conclusions:

• Recurrent childbirth is associated with increased LV end-diastolic volume and myocardial mass, and decreased EF.
• Frequent deliveries, particularly ≥11 births, may contribute to eccentric hypertrophy in women from low-to-middle income countries.