Pregnancy, ovarian function hold clues to risk of female-specific CAD

Having three or more pregnancies, early menopause, and a shorter reproductive life span all contribute to an increased risk of angiographic obstructive coronary artery disease (CAD) in postmenopausal women, according to a study.

The finding suggests that pregnancy and ovarian function may play an important role in the early identification and prevention of increased risk of female angiographic obstructive CAD, researchers said.

The analysis included 1,474 postmenopausal women who presented to the emergency department with chest pain and were referred for invasive coronary angiography. The researchers grouped these women into three—those with apparent, nonobstructive, or obstructive CAD—and identified reproductive risk factors for the latter.

On multivariable logistic regression, factors associated with obstructive CAD included multigravidity (three or more pregnancies; odds ratio [OR], 1.81, 95 percent confidence interval [CI], 1.03–3.17), early menopause (≤40 years; OR, 1.77, 95 percent CI, 1.14–2.76), and short reproductive life span (≤30 years; OR, 1.72, 95 percent CI, 1.26–2.35).

Moreover, every additional year in age at menopause or reproductive life span conferred a 4-percent reduction in obstructive CAD risk in postmenopausal women (OR, 0.96, 95 percent CI, 0.94–0.99; p=0.011).

Other reproductive factors, such as parity, age at first birth, spontaneous abortion, induced abortion, stillbirth, hypertensive disorders of pregnancy, gestational diabetes mellitus, and age at menarche, showed no association with obstructive CAD risk among postmenopausal women.