American Journal of Epidemiology Vol. 144, No. 3: 247-254
Copyright © 1996 by The Johns Hopkins University School of Hygiene and Public Health
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Adverse Effect of Pregnancy on High Density Lipoprotein (HDL) Cholesterol in Young Adult Women
The CARDIA Study
1Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham Birmingham, AL
2Department of Epidemiology, School of Public Health, University of Alabama at Birmingham Birmingham, AL
3Behavioral Medicine Unit, Division of Preventive Medicine, School of Medicine, and Department of Health Behavior, School of Public Health, University of Alabama at Birmingham Birmingham, AL
4Division of Research, Kaiser Permanente Oakland, CA
5Division of Epidemiology and Clinical Applications, National Heart, Lung and Blood Institute Bethesda, MD
6Mediantic Research Institute, Washington, DC
Reprint requests to Dr. Cora E. Lewis, Div. of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Room 734, Birmingham, AL 35205.
The authors analyzed data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study in order to examine associations between parity and lipoproteins. Of 2,787 women recruited in 1985–1986, 2, 534 (91%) returned in 1987–1988 and 2, 393 (86%) returned in 1990–1991 for repeat evaluations. Two-year change (1987–1988 to 1985–1986) in high density lipoprotein (HDL) cholesterol was significantly different among the parity groups. HDL cholesterol decreased in women who had their first pregnancy of at least 28 weeks duration during follow-up (mean ± standard error, –3.5 ±1.2 mg/dl), and this change was significantly different from the increase in women parous at baseline who had no further pregnancies (2.5 ± 0.3 mg/dl) and in nullipara (2.4 ± 0.3 mg/dl). There was a nonsignificant trend for a greater decrease in HDL2 cholesterol fraction in the primipara compared with the other groups. The HDL cholesterol decrease remained significant after controlling for race, age, education, oral contraceptive use, and changes in body mass index, waist-hip ratio, physical activity, smoking status, and alcohol intake. Change in HDL cholesterol was also significantly different among the parity groups in analyses of pregnancies that occurred during the subsequent 3 years of follow-up. There were no differences for change in LDL cholesterol or triglycerides. Potential mechanisms for a detrimental effect of pregnancy on HDL cholesterol include hormonal, body composition, or life-style/ behavioral changes. Am J Epidemiol 1996; 144: 247–54.
lipoproteins; lipoproteins, HDL cholesterol; parity; reproduction; women
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