Parity, Job Strain, and Cardiovascular Risk in the Women’s Health Study
Purpose of Review
Pregnancy and employment are critical life events that can affect chronic disease risk in women. Hence, we examined the relationship between parity and cardiovascular risk, and whether job stress affected this association.
Cox proportional hazard models examined the association of parity with cardiovascular disease (CVD) risk [myocardial infarction (MI), coronary artery revascularization, ischemic stroke, and CVD death] in 23,905 participants in the Women’s Health Study. Parity was defined at baseline as pregnancy lasting > 6 months gestation, categorized as none (referent), 1–2, 3–4, and 5+. Job strain assessed at year 5 was operationalized using the Karasek job strain model, and job insecurity was defined based on the item “My job security is good” (yes or no). The mean age of the women at baseline was 57.3 ± 5.2 years with an average follow-up for CVD of 16 years. In models adjusted for age, race/ethnicity, income, education, CVD risk factors, and age of menarche, increasing parity was associated with increased CVD risk compared to no pregnancies [hazard ratio (HR), 95% confidence interval (CI) 1.15, 0.94–1.41 (1–2 pregnancies); 1.29, 1.06–1.58 (3–4 pregnancies); 1.52, 1.20–1.93 (5+ pregnancies)]. Further adjustment for job strain did not attenuate the noted relationship (HR, 95% CI 1.15, 0.94–1.41 (1–2 pregnancies); 1.30, 1.06–1.58 (3–4 pregnancies); 1.52, 1.20–1.93 (5+ pregnancies). There was no significant interaction between job strain (p = 0.68) or job insecurity (p = 0.97) and parity.
Among working women, increased parity was related to heightened CVD risk, a relationship that was not attenuated by job strain or job insecurity.
KeywordsPregnancy Cardiovascular disease Job stress Parity
We would like to thank the participants of the Women’s Health Study.
The Women’s Health Study is supported by grants HL080467, HL099355, HL043851, CA047988, and UM1- CA182913 from the National Heart, Lung, and Blood Institute and the National Cancer Institute. This study is funded by NIH RO1 grant AG038492 (Dr. MA Albert). Dr. Cabeza de Baca was partially supported by a National Institute of Mental Health training grant T32-MH019391.
Compliance with Ethical Standards
Conflict of Interest
Eva M. Durazo, Tomás Cabeza de Baca, Natalie Slopen, Nisha I. Parikh, Julie E. Buring, Robert J. Glynn, and Michelle A. Albert declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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