Is interpregnancy interval associated with cardiovascular risk factors in later life? A cohort study

OBJECTIVES: Pregnancy represents a metabolic challenge to women; in a normal pregnancy, transient metabolic changes occur that support the needs of the growing fetus. It is possible that repeating this challenge within a relatively short amount of time may result in lasting damage to the woman's cardiovascular health. Conversely, it is also possible that a long interpregnancy interval (IPI) may reflect subfertility, which has been found to be associated with cardiovascular disease (CVD). We examine the associations of short and long IPI with measures of cardiovascular health.

DESIGN: Prospective cohort.

SETTING: Mothers of the Avon Longitudinal Study of Parents and Children (ALSPAC).

PARTICIPANTS: Women with two live births in order to control for confounding by parity.

OUTCOME MEASURES: Arterial distensibility, common carotid intima, adiposity, blood pressure, lipids, glucose, insulin, proinsulin, triglycerides, C reactive protein.

RESULTS: 25% (n=3451) of ALSPAC mothers had provided sufficient data to determine full reproductive history-of these, 1477 had two live births, with 54% mothers having non-missing data on all variables required for our analyses. A total of 1268 mothers with IPI (interbirth interval minus 9 months' gestation) had CVD risk factors measured/imputed at mean age 48 years. After adjusting for confounding, we found no association of either short (≤15 months) or long (>27 months) IPI and increased levels of cardiovascular risk factors. There was some suggestion that women with long and short IPIs had a more favourable lipid profile compared with women whose IPI was 16-27 months; however, the differences were small in magnitude and imprecisely estimated.

CONCLUSIONS: This study does not support the hypothesis that either long or short IPI is a risk factor for later cardiovascular health.