{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:54:51Z","timestamp":1787324091996,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>In the United States, cardiovascular disease (CVD) is a leading cause of death among American Indian women. We examined the associations of parity and pregnancy complications (history of preeclampsia, protein in urine, eclampsia or seizures, gestational diabetes, hypertension) with incident CVD (myocardial infarction, coronary heart disease, congestive heart failure, ischemic stroke) among American Indian women in the Strong Heart Family Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Baseline information was collected between January 2006 and December 2009, and CVD events were evaluated through December 2022. We used clustered logistic regression analyses to assess associations of each parity or pregnancy complications with risk of CVD among women free of CVD at baseline (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 1,203).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We found no statistically significant association of parity with risk of CVD when comparing grand multiparous (\u22655) women (OR = 0.76, 95% CI: 0.39, 1.46;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.41) and moderate parous (2\u20134) women (OR = 1.33; 95% CI: 0.65, 2.71;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.44) to low parous (0\/1) women. We found no statistically significant association of pregnancy complications with risk of CVD (OR = 1.08, 95% CI: 0.62, 1.88;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.78) comparing participants with no pregnancy complications to those with pregnancy complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although not statistically significant, findings support potential positive associations of grand multiparity and pregnancy complications with CVD among American Indian women. Given the limited sample size, more research is needed to assess the impact of multiparity and\/or pregnancy complications on CVD risk among American Indians women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15409996261455858","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T10:20:27Z","timestamp":1780395627000},"page":"965-975","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Pregnancy History and Complications with Cardiovascular Disease Among American Indian Women: The Strong Heart Family Study"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6484-1728","authenticated-orcid":false,"given":"Lyda","family":"Ebadani","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of Washington, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica A.","family":"Reese","sequence":"additional","affiliation":[{"name":"Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen M.","family":"Sitlani","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyle G.","family":"Best","sequence":"additional","affiliation":[{"name":"Missouri Breaks, Research Industries, Eagle Beaut, South Dakota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason G.","family":"Umans","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute, Washington, DC, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Enquobahrie","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda M.","family":"Fretts","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"e_1_3_3_2_1","unstructured":"1.Centers for Disease Control and Prevention (CDC). Leading Causes of Death\u2014Females\u2014Non-Hispanic American Indian or Alaska Native\u2014United States 2018 Centers for Disease Control and Prevention. 2022. Available from: https:\/\/www.cdc.gov\/women\/lcod\/2018\/nonhispanic-native\/index.htm [Last accessed: October12 2023]."},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.34923"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-022-01178-5"},{"key":"e_1_3_3_5_1","unstructured":"4.Heart Disease and American Indians\/Alaska Natives. OMH: U.S. Department of Health and Human Services Office of Minority Health. Available from: https:\/\/minorityhealth.hhs.gov\/heart-disease-and-american-indiansalaska-natives [Last accessed: November1 2023]."},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1117824"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.9122"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7117a1"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-016-2080-3"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2020.8890"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6835a3"},{"key":"e_1_3_3_12_1","unstructured":"11.Population Reference Bureau. Economic Social and Demographic Losses and Gains Among American Indians. PRB. 2004. https:\/\/www.prb.org\/resources\/economic-social-and-demographic-losses-and-gains-among-american-indians\/[October 15 2023]."},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2047487318818265"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms161023905"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-016-0310-4"},{"key":"e_1_3_3_16_1","unstructured":"15.Hudson College of Public Health: The University of Oklahoma Health Sciences Center. Research Overview. Strong Heart Study: The Largest Epidemiologic Study of Cardiovascular Disease in American Indians. https:\/\/strongheartstudy.org\/Research\/Research-Overview [October 16 2023]."},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd22.250216"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd22.240505"},{"key":"e_1_3_3_19_1","unstructured":"18.Cardiovascular Disease in American Indians (Phase V): Operations Manual Volume One. The Strong Heart Study: The Largest Epidemiological Study of Cardiovascular Disease in American Indians. 2006. Available from: https:\/\/strongheartstudy.org\/portals\/1288\/Assets\/documents\/manuals\/Phase%20IV%20Operations%20Manual.pdf?ver=2017-11-15-134610-080 [Last accessed: October18 2023]."},{"key":"e_1_3_3_20_1","unstructured":"19.Cardiovascular Disease in American Indians (Phase IV): Operations Manual Volume One. The Strong Heart Study: The Largest Epidemiological Study of Cardiovascular Disease in American Indians. 2001. https:\/\/strongheartstudy.org\/portals\/1288\/Assets\/documents\/manuals\/Phase%20IV%20Operations%20Manual.pdf?ver=2017-11-15-134610-080 [October 18 2023]."},{"key":"e_1_3_3_21_1","unstructured":"20.Phase Five: Data Dictionary. The Strong Heart Study: The Largest Epidemiological Study of Cardiovascular Disease in American Indians. 2001. https:\/\/strongheartstudy.org\/portals\/1288\/Assets\/documents\/DataDic\/Phase%20V%20Data%20Dictionary.pdf?ver=2022-09-18-183641-843 [October 18 2023]"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd6020019"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2020.12.034"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2018-313005"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-15621-y"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001078"},{"key":"e_1_3_3_27_1","unstructured":"26.Phase Four: Data Dictionary. The Strong Heart Study: The Largest Epidemiological Study of Cardiovascular Disease in American Indians. 2001. https:\/\/strongheartstudy.org\/portals\/1288\/Assets\/documents\/DataDic\/Phase%20IV%20Data%20Dictionary.pdf?ver=2022-09-18-183646-873 [October 18 2023]."},{"issue":"3","key":"e_1_3_3_28_1","first-page":"1","article-title":"mice: Multivariate imputation by chained equations in R","volume":"45","author":"Van Buuren S","year":"2011","unstructured":"27.Van Buuren S, , Groothuis-Oudshoorn K. mice: Multivariate imputation by chained equations in R. J Stat Soft 2011;45(3):1\u201367; doi: 10.18637\/jss.v045.i03","journal-title":"J Stat Soft"},{"key":"e_1_3_3_29_1","unstructured":"28.NOT-OD-22-214: Supplemental Information to the NIH Policy for Data Management and Sharing: Responsible Management and Sharing of American Indian\/Alaska Native Participant Data. Nih.gov. 2022. Available from: https:\/\/grants.nih.gov\/grants\/guide\/notice-files\/NOT-OD-22-214.html [Last accessed: February2 2026]."},{"key":"e_1_3_3_30_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.036748"},{"key":"e_1_3_3_31_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.023079"},{"key":"e_1_3_3_32_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000053441.43495.1A"},{"key":"e_1_3_3_33_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.029942"}],"container-title":["Journal of Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15409996261455858","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15409996261455858","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15409996261455858","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:18:36Z","timestamp":1787321916000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15409996261455858"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,2]]},"references-count":32,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,1]]}},"alternative-id":["10.1177\/15409996261455858"],"URL":"https:\/\/doi.org\/10.1177\/15409996261455858","relation":{},"ISSN":["1540-9996","1931-843X"],"issn-type":[{"value":"1540-9996","type":"print"},{"value":"1931-843X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,2]]}}}