The Effect of Number of Pregnancies on Aortic Stiffness Index, Aortic Velocity Propagation, and Epicardial Fat Thickness

OBJECTIVE
Pregnancy causes physiological, hormonal, and hemodynamic changes that affect the aortic wall dimensions and elastic properties. Multiple pregnancies increase the risk of aortic enlargement and reduce aortic elasticity. The aortic stiffness index (ASI) and aortic velocity propagation (AVP) are markers of elasticity. Additionally, epicardial fat thickness (EFT) is associated with cardiovascular risk factors. The impact of multiparity on ASI, AVP, and EFT has not been previously reported in the literature. Therefore, we aimed to investigate the association of these parameters with the number of live pregnancies in this study.


METHODS
A total of 410 patients were enrolled in this prospective study. Patients were divided into three groups based on the number of live births: Group 1 (n = 0, 128 patients), Group 2 (4 ≥ n > 0, 157 patients), and Group 3 (n ≥ 5, 125 patients). A linear regression analysis was conducted to investigate trend associations of ASI, AVP, and EFT between the study groups. Multiple linear regression analysis was used to evaluate the independent predictors of continuous parameters.


RESULTS
There were increasing trends in multiparity with variables such as aortic systolic (ASD) and diastolic diameters, pulmonary artery diameters, ASI, and EFT, and a decreasing trend in AVP. The number of pregnancies was strongly and positively correlated with ASI, moderately and positively correlated with EFT and ASD, and moderately and negatively correlated with AVP.


CONCLUSION
Multiparity was independently associated with ASI, EFT, ASD, and AVP, reflecting decreased elasticity and elevated cardiovascular risk in multiparous women.