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

OBJECTIVE
Pregnancy causes physiologic, hormonal and hemodynamic changes effecting the aortic wall dimensions and elastic properties. Multiple gestations enhance the risk of aortic enlargement and decrease aortic elasticity. Aortic stiffness index (ASI) and aortic velocity propagation (AVP) are the markers of elasticity. On the other hand, epicardial fat thickness (EFT) is associated with cardiovascular risk factors. The impact of multiparity on ASI, AVP, and EFT has not been reported in the literature previously. Thus, we aimed to investigate the association of these parameters with 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 used 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 towards multiparity with variables, including 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, which reflects decreased elasticity and elevated cardiovascular risk in multiparous women.