Oral or Poster Presentation
Concurrent Session 1A - Perinatal Epidemiology
Introduction: Cardiovascular disease (CVD) is the leading cause of death in women globally. In recent years, attention has turned to female infertility as a potential marker for early mortality and future CVD development. We examined whether female infertility is associated with increased risk of subsequent CVD events.
Methods: The Study of Women’s Health Across the Nation (SWAN) is an ongoing longitudinal cohort study of women’s health in their middle years. Women aged 42-52 with a uterus and at least one intact ovary, a menstrual period, and no hormone medications within three months prior to enrollment were eligible. Infertility was self-reported and defined as no pregnancy after 12 months of trying to conceive. Study outcome was defined as a self-reported CVD event (stroke, myocardial infarction, or angina) over 10 years of annual follow-up. Cox proportional hazards models were used to calculate hazard ratios (HR) for CVD events in women with infertility, with adjustment for covariates, both categorical (race, family history of CVD, insurance, continuous oral contraceptive use from age 25 to 35) and time-varying (hypertension, diabetes, body mass index (BMI), smoking, income, menopausal status).
Results: 493 participants were excluded due to prior CVD event (n=215), missing fertility data (n=97), or missing outcome data (n=181). Of the remaining 2,809 participants, 24% (n=675) had infertility and 5.2% (n=147) experienced a CVD event. After adjustment for covariates, women with infertility did not have a higher risk of cardiovascular events (HR=0.85, 95% CI 0.55-1.31). As expected, family history of CVD, hypertension, diabetes, BMI, smoking, and continuous oral contraceptive use from age 25 to 35 were strongly associated with future CVD events.
Conclusion: Infertility was not associated with increased risk of cardiovascular events after adjusting for relevant covariates. Further research is required to investigate the effects of specific causes of infertility and treatments on CVD outcomes.