The impact of parity on life course blood pressure trajectories: the HUNT study in Norway

  • Eirin B. Haug
  • Julie Horn
  • Amanda Rose Markovitz
  • Abigail Fraser
  • Corrie Macdonald-Wallis
  • Kate Tilling
  • Pål Richard Romundstad
  • Janet Wilson Rich-Edwards
  • Bjørn Olav Åsvold


The drop in blood pressure during pregnancy may persist postpartum, but the impact of pregnancy on blood pressure across the life course is not known. In this study we examined blood pressure trajectories for women in the years preceding and following pregnancy and compared life course trajectories of blood pressure for parous and nulliparous women. We linked information on all women who participated in the population-based, longitudinal HUNT Study, Norway with pregnancy information from the Medical Birth Registry of Norway. A total of 23,438 women were included with up to 3 blood pressure measurements per woman. Blood pressure trajectories were compared using a mixed effects linear spline model. Before first pregnancy, women who later gave birth had similar mean blood pressure to women who never gave birth. Women who delivered experienced a drop after their first birth of − 3.32 mmHg (95% CI, − 3.93, − 2.71) and − 1.98 mmHg (95% CI, − 2.43, − 1.53) in systolic and diastolic blood pressure, respectively. Subsequent pregnancies were associated with smaller reductions. These pregnancy-related reductions in blood pressure led to persistent differences in mean blood pressure, and at age 50, parous women still had lower systolic (− 1.93 mmHg; 95% CI, − 3.33, − 0.53) and diastolic (− 1.36 mmHg; 95% CI, − 2.26, − 0.46) blood pressure compared to nulliparous women. The findings suggest that the first pregnancy and, to a lesser extent, successive pregnancies are associated with lasting and clinically relevant reductions in systolic and diastolic blood pressure.


Life course Blood pressure Parity Pregnancy Epidemiology 



The Nord-Trøndelag Health Study (The HUNT Study) is a collaboration between HUNT Research Centre (Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology), Nord-Trøndelag County Council, Central Norway Health Authority, and the Norwegian Institute of Public Health.


This work was supported by the Research Council of Norway (grant number 231149/F20) to BOÅ, JH, and EBH. BOÅ was also supported by the The Liaison Committee for education, research and innovation in Central Norway, and by the Fulbright Program. AF is supported by a personal fellowship from the UK MRC (grant number MR/M009351/1). AF and KT work in a Unit that receives core funding from UK MRC (grant number MC_UU_12013/5). This work was also supported by the American Heart Association (grant number 16PRE29690006) to AM.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

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Supplementary material 1 (DOCX 456 kb)


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Eirin B. Haug
    • 1
  • Julie Horn
    • 1
    • 4
  • Amanda Rose Markovitz
    • 2
    • 5
  • Abigail Fraser
    • 3
  • Corrie Macdonald-Wallis
    • 3
  • Kate Tilling
    • 3
  • Pål Richard Romundstad
    • 1
  • Janet Wilson Rich-Edwards
    • 2
    • 5
  • Bjørn Olav Åsvold
    • 1
    • 6
  1. 1.Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
  2. 2.The Harvard T.H Chan School of Public HealthHarvard UniversityBostonUSA
  3. 3.MRC Integrative Epidemiology Unit and Population Health SciencesUniversity of BristolBristolUK
  4. 4.Department of Obstetrics and Gynecology, Levanger HospitalNord-Trøndelag Hospital TrustLevangerNorway
  5. 5.Connors Center for Women’s Health and Gender Biology, Brigham and Women’s HospitalHarvard Medical ShcoolBostonUSA
  6. 6.Department of Endocrinology, St. Olavs HospitalTrondheim University HospitalTrondheimNorway

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