Abstract MP19: Higher Parity is Associated With Components of the Metabolic Syndrome Among U.S. Hispanic/Latina Women: Results From the HCHS/SOL Study
Authors: Vladutiu Catherine J , Siega-Riz Anna Maria , Stuebe Alison M , Sotres-Alvarez Daniela , Ni Andy , Potter JoNell E , Tabb Karen M , Gallo Linda C , Daviglus Martha , Carnethon Mercedes , Smoller Sylvia , Heiss Gerardo 
Published: July 2021

Background:
Physiologic adaptations occurring across successive pregnancies may increase the risk of adverse cardiovascular health outcomes in later life. Previous studies have found an association between higher parity and the metabolic syndrome (MetS). However, no studies have examined this association in a Hispanic/Latina population. Hispanic women have a higher prevalence of the MetS and higher birth rates than non-Hispanic women.

Hypothesis:
We assessed the hypothesis that higher parity is associated with the prevalence of components of the MetS in a cohort of Hispanic/Latina women.

Methods:
There were 9,482 Hispanic/Latina women of diverse backgrounds, aged 18-74 years, who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from 2008-2011. Components of the MetS were defined according to the AHA/NHLBI criteria and included abdominal obesity (waist circumference ≥88cm), elevated triglycerides (≥150 mg/dL), low HDL cholesterol (<50mg/dL), high blood pressure (systolic ≥130mmHg or diastolic ≥85mmHg or on medication), and elevated fasting glucose (≥100mg/dL or on medication). Logistic regression models were used to estimate odds ratios for the association between parity and components of the MetS, adjusting for sociodemographic, behavioral, and reproductive characteristics, and accounting for the complex survey design and sampling weights.

Results:
At HCHS/SOL baseline, women reported none (19.2%), one (18.9%), two (25.3%), three (19.7%), four (9.3%), and five or more (7.6%) prior live births. Compared to women with only one live birth, women with four live births had the highest odds of abdominal obesity (OR=2.5, 95% CI 1.8, 3.3) and those with five or more live births had the highest odds of low HDL cholesterol (OR=1.5, 95% CI 1.2, 1.9), elevated glucose (OR=1.8, 95% CI 1.3, 2.3), elevated triglycerides (OR=1.4, 95% CI 1.01, 1.8), and high blood pressure (OR=1.5, 95% CI 1.1, 2.0), after adjusting for age, Hispanic background, education, marital status, income, nativity, smoking, physical activity, menopause status, oral contraceptive use, hormone replacement therapy, and field center. Further adjustment for body mass index attenuated these associations for all MetS components, including abdominal obesity (OR=1.5, 95% CI 1.1, 2.2), low HDL cholesterol (OR=1.3, 95% CI 1.03, 1.7), and elevated glucose (OR=1.6, 95% CI 1.2, 2.1), but the associations for triglycerides and blood pressure were no longer statistically significant.

Conclusion:
Higher parity is associated with the prevalence of selected components of the MetS among U.S. Hispanic/Latina women. High parity among Latinas with a high prevalence of abdominal obesity suggests a context of high risk for metabolic dysregulation. A better characterization of the links between pregnancy, adiposity, and body fat distribution is needed.