{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T02:37:49Z","timestamp":1784774269812,"version":"3.55.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2001,10]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Background and Purpose<\/jats:italic>\n                <\/jats:bold>\n                \u2014\n              <\/jats:italic>\n            <\/jats:bold>\n            It has been postulated that physiological changes in the cardiovascular system, lipids, and glucose metabolism during pregnancy may increase subsequent risk of cardiovascular disease. Examination of the association between parity and risk factors for atherosclerosis may contribute information regarding possible mechanisms.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Methods<\/jats:italic>\n                <\/jats:bold>\n                \u2014\n              <\/jats:italic>\n            <\/jats:bold>\n            The relationship of parity with cardiovascular risk factors and the presence of carotid atherosclerosis was examined in the Rotterdam Study, a population-based study comprising 4878 women aged 55 years and older. Carotid atherosclerosis was assessed by ultrasonographic detection of plaques in the common carotid artery and bifurcation. Logistic regression models were used to compute odds ratios and 95% confidence intervals, adjusted for confounding factors.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Results<\/jats:italic>\n                <\/jats:bold>\n                \u2014\n              <\/jats:italic>\n            <\/jats:bold>\n            Parity was inversely associated with high-density lipoprotein cholesterol, and alcohol intake. Parity was positively associated with body mass index, total\/HDL cholesterol ratio, insulin resistance, age at menopause, and socioeconomic status. Relative to nulliparous women, parous women had 36% (9% to 71%) greater risk of carotid atherosclerosis, rising to 64% in women with \u22654 children (19% to 127%). Adjustment for known cardiovascular risk factors, including insulin resistance and current lipid levels, did not diminish the magnitude of this association.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Conclusions<\/jats:italic>\n                <\/jats:bold>\n                \u2014\n              <\/jats:italic>\n            <\/jats:bold>\n            Data demonstrated that there is a positive association between parity and risk of carotid artery plaques in elderly women and, further, that high parity is associated with lower HDL cholesterol levels and higher glucose\/insulin ratios long after childbearing has ceased.\n          <\/jats:p>","DOI":"10.1161\/hs1001.097224","type":"journal-article","created":{"date-parts":[[2007,10,10]],"date-time":"2007-10-10T17:46:58Z","timestamp":1192038418000},"page":"2259-2264","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":83,"title":["Parity and Carotid Artery Atherosclerosis in Elderly Women"],"prefix":"10.1161","volume":"32","author":[{"given":"Karin H.","family":"Humphries","sequence":"first","affiliation":[{"name":"From the Centre for Health Evaluation and Outcome Sciences (K.H.H.), St Paul\u2019s Hospital, the Department of Health Care and Epidemiology, University of British Columbia (J.J.S.), and the Division of Cardiology, St Paul\u2019s Hospital and Department of Medicine, University of British Columbia (R.G.C.), Vancouver, Canada; and the Department of Epidemiology and Biostatistics, Erasmus Medical Centre Rotterdam (I.C.D.W., A.H., J.C.M.W.), Rotterdam, the Netherlands, and Julius Center for Patient Oriented..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris C.D.","family":"Westendorp","sequence":"additional","affiliation":[{"name":"From the Centre for Health Evaluation and Outcome Sciences (K.H.H.), St Paul\u2019s Hospital, the Department of Health Care and Epidemiology, University of British Columbia (J.J.S.), and the Division of Cardiology, St Paul\u2019s Hospital and Department of Medicine, University of British Columbia (R.G.C.), Vancouver, Canada; and the Department of Epidemiology and Biostatistics, Erasmus Medical Centre Rotterdam (I.C.D.W., A.H., J.C.M.W.), Rotterdam, the Netherlands, and Julius Center for Patient Oriented..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel L.","family":"Bots","sequence":"additional","affiliation":[{"name":"From the Centre for Health Evaluation and Outcome Sciences (K.H.H.), St Paul\u2019s Hospital, the Department of Health Care and Epidemiology, University of British Columbia (J.J.S.), and the Division of Cardiology, St Paul\u2019s Hospital and Department of Medicine, University of British Columbia (R.G.C.), Vancouver, Canada; and the Department of Epidemiology and Biostatistics, Erasmus Medical Centre Rotterdam (I.C.D.W., A.H., J.C.M.W.), Rotterdam, the Netherlands, and Julius Center for Patient Oriented..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Spinelli","sequence":"additional","affiliation":[{"name":"From the Centre for Health Evaluation and Outcome Sciences (K.H.H.), St Paul\u2019s Hospital, the Department of Health Care and Epidemiology, University of British Columbia (J.J.S.), and the Division of Cardiology, St Paul\u2019s Hospital and Department of Medicine, University of British Columbia (R.G.C.), Vancouver, Canada; and the Department of Epidemiology and Biostatistics, Erasmus Medical Centre Rotterdam (I.C.D.W., A.H., J.C.M.W.), Rotterdam, the Netherlands, and Julius Center for Patient Oriented..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald G.","family":"Carere","sequence":"additional","affiliation":[{"name":"From the Centre for Health Evaluation and Outcome Sciences (K.H.H.), St Paul\u2019s Hospital, the Department of Health Care and Epidemiology, University of British Columbia (J.J.S.), and the Division of Cardiology, St Paul\u2019s Hospital and Department of Medicine, University of British Columbia (R.G.C.), Vancouver, Canada; and the Department of Epidemiology and Biostatistics, Erasmus Medical Centre Rotterdam (I.C.D.W., A.H., J.C.M.W.), Rotterdam, the Netherlands, and Julius Center for Patient Oriented..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Hofman","sequence":"additional","affiliation":[{"name":"From the Centre for Health Evaluation and Outcome Sciences (K.H.H.), St Paul\u2019s Hospital, the Department of Health Care and Epidemiology, University of British Columbia (J.J.S.), and the Division of Cardiology, St Paul\u2019s Hospital and Department of Medicine, University of British Columbia (R.G.C.), Vancouver, Canada; and the Department of Epidemiology and Biostatistics, Erasmus Medical Centre Rotterdam (I.C.D.W., A.H., J.C.M.W.), Rotterdam, the Netherlands, and Julius Center for Patient Oriented..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline C.M.","family":"Witteman","sequence":"additional","affiliation":[{"name":"From the Centre for Health Evaluation and Outcome Sciences (K.H.H.), St Paul\u2019s Hospital, the Department of Health Care and Epidemiology, University of British Columbia (J.J.S.), and the Division of Cardiology, St Paul\u2019s Hospital and Department of Medicine, University of British Columbia (R.G.C.), Vancouver, Canada; and the Department of Epidemiology and Biostatistics, Erasmus Medical Centre Rotterdam (I.C.D.W., A.H., J.C.M.W.), Rotterdam, the Netherlands, and Julius Center for Patient Oriented..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199305273282104"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199312163292515"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.297.6645.391"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199611000-00014"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114723"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.epirev.a036155"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70351-4"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00738-8"},{"key":"e_1_3_2_9_2","first-page":"627","volume":"256","year":"1991","unstructured":"Barrett-Connors E, Cohn B, Wingard D, Edelstein S. Why is diabetes mellitus a stronger risk factor for fatal ischemic heart disease in women than in men? The Rancho Bernardo Study. JAMA. 1991; 256: 627\u2013631.","journal-title":"JAMA"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115483"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.79.1.2642759"},{"key":"e_1_3_2_12_2","first-page":"468","volume":"66","year":"1985","unstructured":"Fahreaus L, Larsson-Cohn U, Wallentin L. Plasma lipoproteins including high density lipoprotein subfractions during normal pregnancy. Obstet Gynecol. 1985; 66: 468\u2013477.","journal-title":"Obstet Gynecol"},{"key":"e_1_3_2_13_2","first-page":"20","volume":"63","year":"1984","unstructured":"Ordovas J, Pocovi M, Grande F. Plasma lipids and cholesterol esterification rate during pregnancy. Obstet Gynecol. 1984; 63: 20\u201325.","journal-title":"Obstet Gynecol"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a008919"},{"key":"e_1_3_2_15_2","first-page":"253","volume":"95","year":"1997","unstructured":"Barrett-Connors E. Sex differences in coronary heart disease. Circulation. 1997; 95: 253\u2013264.","journal-title":"Circulation"},{"key":"e_1_3_2_16_2","doi-asserted-by":"crossref","unstructured":"Kuller L Shemanski L Psaty B Borhani N Gardin J Haan M O\u2019Leary D Savage P Tell G Tracy R. Subclinical disease as an independent risk factor for cardiovascular disease. Circulation. 1995; 92.","DOI":"10.1161\/01.CIR.92.4.720"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/atv91.11.6.1931880"},{"key":"e_1_3_2_18_2","first-page":"1293","volume":"53","year":"1962","unstructured":"Mitchell J, Schwartz C. Relationship between arterial disease in different sites: a study of aorta and coronary, carotid and iliac arteries. BMJ. 1962; 53: 1293\u20131301.","journal-title":"BMJ"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00145007"},{"key":"e_1_3_2_20_2","first-page":"115","volume":"2","year":"1988","unstructured":"Buhmann B, Rainwater L, Schmaus G, et al. Equivalence scales, well-being, inequality, and poverty: sensitivity estimates across ten countries using the Luxembourg Income Study (LIS) data base. Rev Income Wealth. 1988; 2: 115\u2013142.","journal-title":"Rev Income Wealth"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009028"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199312303292703"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/0009-8981(77)90195-4"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.96.5.1432"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)90196-1"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-122-5-199503010-00007"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.39.4.343"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1997.00550140073015"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114729"},{"key":"e_1_3_2_30_2","first-page":"205","volume":"1980","year":"1980","unstructured":"Ducimetiere P, Eschwege E, Papoz L, Richard J, Claude J, Rosselin G. Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population. Diabetologia. 1980; 1980: 205\u2013210.","journal-title":"Diabetologia"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.13.6.631"},{"key":"e_1_3_2_32_2","first-page":"857","volume":"140","year":"1995","unstructured":"Ferrara A, Barrett-Connors E, Wingard D. Hyperinsulinemia does not increase the risk of fatal cardiovascular disease in elderly men or women without diabetes: the Rancho Bernardo Study. Am J Epidemiol. 1995; 140: 857\u2013869.","journal-title":"Am J Epidemiol"},{"key":"e_1_3_2_33_2","first-page":"583","volume":"14","year":"1990","unstructured":"Kaye S, Folsom A, Prineas R, Potter J, Gapstur S. The associations of body fat distribution with lifestyle and reproductive factors in a population study of postmenopausal women. Int J Obes. 1990; 14: 583\u2013591.","journal-title":"Int J Obes"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198911023211802"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/hs1001.097224","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T02:19:01Z","timestamp":1715653141000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/hs1001.097224"}},"subtitle":["The Rotterdam Study"],"short-title":[],"issued":{"date-parts":[[2001,10]]},"references-count":34,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2001,10]]}},"alternative-id":["10.1161\/hs1001.097224"],"URL":"https:\/\/doi.org\/10.1161\/hs1001.097224","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,10]]},"assertion":[{"value":"2000-11-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2001-06-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2001-10-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}