Reproductive History of Women Dying of Sudden Cardiac Death: A Case-Control Study

Abstract

TALBOTT E O (Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennysylvania, 15261, USA), Kuller L H, Detre K, Matthews K, Norman S, Kelsey S F and Belle S. Reproductive history of women dying of sudden cardiac death, a case-control study. International Journal of Epidemiology 1989, 18: 589–594 Reproductive history events may be risk factors for sudden coronary death (SCD) among women. A retrospective case-control study of SCD among women aged 25–64 was conducted in Allegheny County, Pennyslvania. The present analysis focused on a description and analysis involving the childbearing and reproductive history of 67 ever-married female SCD cases and 73 ever-married neighbourhood controls with a mean age of 54.6 and 53.4 years respectively. Information included: age and number of years married, number of children, age at first birth, cardiovascular risk factors, obstetric and gynaecological history. Age and the risk factors, history of hypertension or diabetes, cigarette intake, death of significant other and psychiatric disease, were controlled for in the analysis. More cases than controls experienced their first birth before age 20 (14 of the SCD and 7 controls). However, after adjustment for cigarette smoking status, a strong predictor of sudden cardiac death, the effect of early childbearing did not remain significant for this population. In women ≤ 50 years of age, childlessness was not a risk factor for SCD (1 of 16 cases and 2 of 26 controls were childless). However in women greater than 50 years of age, childlessness was a significant predictor of SCD (OR =6.7 (1.3-32)) 12 of 51 cases were childless compared to 2 of 46 controls. After adjustment for age and other coronary heart disease (CHD) risk factors, the relationship of nulliparity with sudden cardiac death remained in this age group. There was no difference in hysterectomy or miscarriage history or in the total years married between cases and controls. It appears childbearing history may be an important correlate of subsequent history of CHD.