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Self-reported infertility and longitudinal measures of cardiovascular risk factors: The CARDIA study
Catherine Kim1, Duke Appiah2, Zhe Yin3
1Departments of Medicine, Obstetrics & Gynecology, and Epidemiology, Ann Arbor, University of Michigan, Michigan, United States of America.
Insights
Infertility in women is linked to adverse cardiovascular disease (CVD) risk factors. Cigarette smoking emerged as the strongest predictor of self-reported infertility in a large cohort study.
Area of Science:
- Cardiovascular disease research
- Reproductive health
- Epidemiology
Background:
- Previous studies suggest a link between female infertility and increased cardiovascular disease (CVD) risk.
- Conflicting reports exist regarding the association between infertility and specific CVD risk factors.
- This study investigates the relationship between longitudinal CVD risk factors and infertility in a diverse population.
Purpose of the Study:
- To examine the association between infertility and cardiovascular disease (CVD) risk factors over time.
- To identify specific CVD risk factors associated with infertility in women.
- To analyze data from a population-based cohort of Black and White women.
Main Methods:
- Utilized data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective cohort.
- Assessed repeated measures of CVD risk factors including smoking, BMI, blood pressure, lipids, glucose, and C-reactive protein.
- Employed generalized estimating equations to analyze associations between infertility and CVD risk factors in 1107 women.
Main Results:
- Infertility was associated with cigarette use, higher BMI, glucose, and triglycerides, and lower HDL cholesterol.
- Cigarette smoking demonstrated the strongest association with self-reported infertility (OR 1.85, 95% CI 1.64-2.14).
- These associations remained significant after adjusting for age, race, and education.
Conclusions:
- Women with a history of infertility exhibit unfavorable cardiovascular disease (CVD) risk factor profiles throughout their reproductive lives.
- Cigarette use is identified as the primary CVD risk factor associated with women's self-reported infertility.
- Findings highlight the importance of addressing CVD risk factors in women experiencing infertility.
Introduction:
Previous reports have noted associations between infertility in women and increased risk of cardiovascular disease (CVD) events in later life. However, reports conflict regarding the associations between infertility and CVD risk factors. Using data from a population-based cohort of Black and White women, we examined the association between longitudinal assessments of CVD risk factors and infertility.
Methods:
The Coronary Artery Risk Development in Young Adults (CARDIA) study is a prospective cohort of Black and White women who have undergone repeated assessment of CVD risk factors beginning at study baseline (1985-1986). Risk factors included cigarette smoking, body mass index (BMI), blood pressure, lipid levels, glucose, and C-reactive protein. At approximately 40 years of age, an ancillary study assessed histories of infertility. We used generalized estimating equations with a logit link model to examine associations between infertility (dependent variable) and repeated CVD risk factors (independent variables), with adjustment for age, race, center, and education level in 1107 women.
Results:
Cigarette use and higher levels of BMI, glucose, and triglycerides and lower levels of high-density lipoprotein cholesterol (HDL) were associated with infertility after adjustment for age, race, and education. Cigarette use had the strongest associations with self-reported infertility in multivariable models (odds ratio 1.85, 95% confidence interval 1.64, 2.14).
Conclusions:
Women with infertility histories have adverse CVD risk factors across the reproductive lifespan, but cigarette use is the primary CVD risk factor for women's self-reported infertility.
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