Giving birth many times linked to increased risk of heart disease

July 1, 2010, Lancet

Palestinian women frequently give birth many times. This has given researchers in the oPt a unique opportunity to study the effects of numbers of births per woman (parity) on risk of coronary heart disease, since previous studies have lacked high numbers of women giving birth more than six times. In this Abstract, the researchers, led by Dr Najwa Odeh Rizkallah, UNICEF Jerusalem, oPT, conclude that parity is linked to obesity, high blood triglyercide concentrations, and increased risk of metabolic syndrome. Any of these factors, alone or in combination, can in turn increase incidence of coronary heart diseases.

The researchers studies women in the Amaari and Kalandia refugee camps in the oPt. They selected a random sample of 515 of all 587 women aged 40-65 who lived in the camps. Women were told by letter the purpose of the project and invited to take part. 15 women who did not give a blood sample were excluded. The other 500 had the blood fats and sugar measured, and assessments of obesity, diabetes, (hypertension) and were made.

Mean parity of the women enrolled was 7.3 births. More than two thirds (69%) of the women were obese, 84% had central obesity (waist circumference greater or equal to 88 cm), and over half (52%)had abdominal obesity (high waist-to-hip ratio). One in five women (22%) had diabetes, while two in five (43%) had hypertension. Following data adjustment for age and other factors, each additional birth increased body-mass index by 0.3kg/m2, by 0.58cm, and blood triglyceride concentrations by 0.036mmol/L. Women found to have metabolic syndrome (58%) had much higher parity than those without.

The authors conclude: "In Palestinian women, high parity was significantly associated with , triglyceride concentration, and increased risk of metabolic syndrome. Any of these risk factors, alone or in combination, could result in increased incidence of . Future studies should investigate the effect of birth spacing and intervals."

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