{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:03:27Z","timestamp":1789715007247,"version":"4.0.1"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,4,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Female\u2010specific reproductive factors have been associated with stroke risk, although evidence for some factors (eg, live births) remains conflicting. We determined the association between number of live births and other female\u2010specific reproductive factors and subsequent risk of stroke and magnetic resonance imaging markers of vascular brain injury in a community\u2010based cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This was a prospective cohort study of 1882 (mean age, 61.3\u00b19.6\u2009years) women from the FHS (Framingham Heart Study) Offspring cohort who were stroke free at the baseline examination (1998\u20132001). Reproductive factors included number of live births, age at menopause, postmenopausal hormone replacement therapy use and serum estradiol and estrone levels. The primary outcome was incident all\u2010cause stroke, with covert brain infarcts and white matter hyperintensity volume on brain magnetic resonance imaging as cross\u2010sectional secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      During a median 18\u2010year follow\u2010up, 126 women had a stroke. On multivariable Cox proportional hazards models controlling for vascular risk factors, \u22653 live births (versus 0, reference) was associated with a reduced risk of stroke (hazard ratio, 0.51 [95% CI, 0.31\u20130.85];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.01). More live births (\u22653 versus 0) was cross\u2010sectionally associated with decreased risk of covert brain infarct (odds ratio, 0.52 [95% CI, 0.30\u20130.92];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.03). No significant association was detected between other reproductive factors and incident stroke or magnetic resonance imaging markers of vascular brain injury.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">A greater number of live births was associated with a decreased risk of stroke and covert brain infarct in women and may be an important factor to include in female\u2010specific clinical prediction rules for stroke.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.044037","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T11:05:31Z","timestamp":1773831931000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Number of Live Births as a Protective Factor Against Clinical and Covert Brain Infarcts: The Framingham Heart Study"],"prefix":"10.1161","volume":"15","author":[{"given":"Senan","family":"Maher","sequence":"first","affiliation":[{"name":"University of Galway","place":["Galway, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1404-4437","authenticated-orcid":false,"given":"Matthew R.","family":"Scott","sequence":"additional","affiliation":[{"name":"The Framingham Heart Study","place":["Framingham, USA"]},{"name":"Boston University Chobanian & Avedisian School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5356-5537","authenticated-orcid":false,"given":"Rachel F.","family":"Buckley","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital and Harvard Medical School","place":["Boston, USA"]},{"name":"Brigham and Women\u2019s Hospital","place":["Boston, USA"]},{"name":"Melbourne School of Psychological Science and Florey Institutes, University of Melbourne","place":["Melbourne, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1914-2693","authenticated-orcid":false,"given":"Charles S.","family":"DeCarli","sequence":"additional","affiliation":[{"name":"University of California","place":["Davis, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8584-1455","authenticated-orcid":false,"given":"Hugo J.","family":"Aparicio","sequence":"additional","affiliation":[{"name":"The Framingham Heart Study","place":["Framingham, USA"]},{"name":"Boston University Chobanian & Avedisian School of Medicine","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1101-2950","authenticated-orcid":false,"given":"Jose Rafael","family":"Romero","sequence":"additional","affiliation":[{"name":"The Framingham Heart Study","place":["Framingham, USA"]},{"name":"Boston University Chobanian & Avedisian School of Medicine","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7357-5970","authenticated-orcid":false,"given":"Ramachandran S.","family":"Vasan","sequence":"additional","affiliation":[{"name":"The Framingham Heart Study","place":["Framingham, USA"]},{"name":"University of Texas School of Public Health San Antonio","place":["San Antonio, USA"]},{"name":"University of Texas Health Science Center","place":["San Antonio, USA"]},{"name":"University of Texas Health Science Center","place":["San Antonio, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0192-7516","authenticated-orcid":false,"given":"Joanne M.","family":"Murabito","sequence":"additional","affiliation":[{"name":"Boston University Chobanian & Avedisian School of Medicine","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalender","family":"Bhasin","sequence":"additional","affiliation":[{"name":"Research Program in Men\u2019s Health, Aging and Metabolism, Department of Medicine, Boston Claude D. 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