Related Experiment Videos

Life-Course Fertility and Cardio-Kidney-Metabolic Health in Chinese Middle-Aged and Older Women: A Cross-Sectional

JiaPing Lu1, Heng Xu1, Qiulian Xu1

  • 1Jinhua People's Hospital.

Research Square
|August 20, 2026
PubMed

Insights

Parity shows a U-shaped link with cardio-kidney-metabolic (CKM) syndrome in older Chinese women. This suggests a "healthy mother effect" where having 2-3 children may offer protection against CKM syndrome.

Area of Science:

  • Reproductive Health
  • Metabolic Syndrome
  • Cardiovascular Health
  • Renal Health

Background:

  • The cardio-kidney-metabolic (CKM) syndrome, a unified framework for cardiovascular, renal, and metabolic dysfunction, was conceptualized by the AHA in 2023.
  • Fertility history, including parity, may impact long-term health due to hormonal and physiological changes.
  • No prior studies have investigated the association between parity and CKM syndrome stages globally.

Purpose of the Study:

  • To examine the association between parity and the stages of cardio-kidney-metabolic (CKM) syndrome.
  • To explore the potential U-shaped relationship between the number of children and CKM syndrome risk.
  • To investigate multimorbidity patterns associated with parity and CKM syndrome.

Main Methods:

  • Cross-sectional analysis of 4,814 Chinese women aged 45+ from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018).
  • CKM stages classified using biomarkers, including cystatin C-based estimated glomerular filtration rate (eGFR).
  • Poisson regression and restricted cubic splines (RCS) used to assess parity-CKM associations and dose-response relationships; factor analysis identified multimorbidity patterns.

Main Results:

  • A prevalence of 53.2% for CKM Stage 2 or higher was observed.
  • A U-shaped association was found between parity and CKM syndrome, with the lowest risk at parity 2-3.
  • Factor analysis identified distinct multimorbidity patterns, including respiratory-cardio-arthritic and digestive-arthritic-renal clusters.

Conclusions:

  • Parity demonstrates a significant U-shaped association with CKM syndrome in middle-aged and older Chinese women.
  • Findings suggest a potential
  • healthy mother effect
  • with protective pathways linked to parity.
  • Integrating fertility history into sex-specific CKM risk assessments is recommended.
Abstract

Keywords:
CHARLSCardio-kidney-metabolic syndromecystatin Cexploratory factor analysisfertility historylife coursemultimorbidityparitywomen’s health

Related Concept Videos

Longitudinal Research02:20

Longitudinal Research

Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again...
Longitudinal Studies01:26

Longitudinal Studies

Longitudinal studies are also widely used in other medical and social science fields. For instance, in cardiovascular research, they can monitor patients' health over decades to identify risk factors for heart disease, such as high cholesterol or smoking, and evaluate the long-term effectiveness of preventive measures. Similarly, in mental health studies, researchers might follow individuals from adolescence into adulthood to understand the development and progression of conditions like...