{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:42:18Z","timestamp":1793295738960,"version":"4.5.0"},"reference-count":68,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Fertility status is a marker for future health, and infertility has been associated with risk for later cancer and diabetes, but associations with midlife cardiovascular health (CVH) in female individuals remain understudied.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate the association of infertility history with CVH at midlife (approximately age\u200950 years) among parous individuals.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>Project Viva is a prospective cohort study of pregnant participants enrolled between 1999 and 2002 who delivered a singleton live birth in the greater Boston, Massachusetts, area. Infertility history was collected at a midlife visit between 2017 and 2021,\u2009approximately\u200918 years after enrollment. Data analysis was performed from January to June 2023.<\/jats:p><\/jats:sec>Exposures<\/jats:title>The primary exposure was any lifetime history of infertility identified by self-report, medical record, diagnosis, or claims for infertility treatment.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The American Heart Association\u2019s Life\u2019s Essential 8 (LE8) is a construct for ranking CVH that includes scores from 0 to 100 (higher\u2009scores denote\u2009better health status) in 4 behavioral (diet, physical activity, sleep, and smoking status) and 4 biomedical (body mass index, blood pressure, blood lipids, and glycemia) domains to form an overall assessment of CVH. Associations of a history of infertility (yes or no) with mean LE8 total, behavioral, biomedical, and blood biomarker (lipids and glycemia) scores were examined, adjusting for age at outcome (midlife visit), race and ethnicity, education, household income, age at menarche, and perceived body size at age 10 years.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 468 included participants (mean [SD] age at the midlife visit, 50.6 [5.3] years) with exposure and outcome data, 160 (34.2%) experienced any infertility. Mean (SD) LE8 scores were 76.3 (12.2) overall, 76.5 (13.4) for the behavioral domain, 76.0 (17.5) for the biomedical domain, and 78.9 (19.2) for the blood biomarkers subdomain. In adjusted models, the estimated overall LE8 score at midlife was 2.94 points lower (95% CI, \u22125.13 to \u22120.74 points), the biomedical score was 4.07 points lower (95% CI, \u22127.33 to \u22120.78 points), and the blood subdomain score was 5.98 points lower (95% CI, \u22129.71 to \u22122.26 points) among those with vs without history of infertility. The point estimate also was lower for the behavioral domain score (\u03b2\u2009=\u2009\u22121.81; 95% CI, \u22124.28 to 0.66), although the result was not statistically significant.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This cohort study of parous individuals found evidence for an association between a history of infertility and lower overall and biomedical CVH scores. Future study of enhanced cardiovascular preventive strategies among those who experience infertility is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.50424","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T16:30:45Z","timestamp":1704472245000},"page":"e2350424","source":"Crossref","is-referenced-by-count":35,"title":["History of Infertility and Midlife Cardiovascular Health in Female Individuals"],"prefix":"10.1001","volume":"7","author":[{"given":"Amy R.","family":"Nichols","sequence":"first","affiliation":[{"name":"Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts"},{"name":"Department of Nutrition, Harvard T. H. 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H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-France","family":"Hivert","sequence":"additional","affiliation":[{"name":"Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts"},{"name":"Diabetes Unit, Massachusetts General Hospital, Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge E.","family":"Chavarro","sequence":"additional","affiliation":[{"name":"Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts"},{"name":"Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts"},{"name":"Department of Epidemiology, Harvard T. H. 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