{
  "abstract": "Background We investigated the association of reproductive history with cardiometabolic health in ethnically diverse women across five continents.Methods We pooled cross-sectional survey data on non-pregnant women aged 30–49 years from 15 countries. Multilevel models were used to examine associations between menopausal status, age at first birth (≥20 vs <20 years), parity (1, 2, 3, 4+ vs 0 births) and cardiometabolic indicators: body mass index (BMI), systolic blood pressure (SBP) and fasting blood glucose (FBG), adjusting for age and socioeconomic status.Results We included 413 802 women (median age 38 years; 14% postmenopausal). Being in a postmenopausal state was associated with lower BMI (−0.22, 95% CI −0.27 to –0.17 kg/m 2) and higher SBP (0.35, 95% CI 0.18, 0.52 mm Hg). In parous premenopausal women (n=332 569), later age at first birth was associated with lower BMI (−0.33, 95% CI −0.36 to –0.30 kg/m²) and lower SBP (−0.59, 95% CI −0.69 to –0.48 mm Hg); higher parity was associated with higher BMI (0.11–0.14 kg/m² for 1–3 births) and lower SBP (−0.77 to −2.04 mm Hg for 1–4+ births). Among parous postmenopausal women (n=55 788), later age at first birth was associated with lower BMI (−0.15, 95% CI −0.23 to –0.07 kg/m²), lower SBP (−0.38, 95% CI −0.67 to –0.08 mm Hg) and higher FBG (2.08, 95% CI 0.08 to 4.11 mg/dL); higher parity was associated with lower SBP (−1.60 to −3.06 mm Hg for 1–4+ births).Conclusions Irrespective of menopausal status, later age at first birth was associated with lower BMI and SBP, while higher parity was associated with lower SBP. Reproductive history has implications for cardiometabolic risk in women across diverse settings.",
  "authors": [
    {
      "affiliations": [
        "Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia, USA"
      ],
      "name": "Wilhemina Quarpong"
    },
    {
      "affiliations": [
        "Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia, USA",
        "Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University, Emory University, Atlanta, Georgia, USA"
      ],
      "name": "Suchitra Chandrasekaran"
    },
    {
      "affiliations": [
        "Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia, USA",
        "Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University, Emory University, Atlanta, Georgia, USA",
        "Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA"
      ],
      "name": "K M Venkat Narayan"
    },
    {
      "affiliations": [
        "Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia, USA",
        "Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA"
      ],
      "name": "Usha Ramakrishnan"
    },
    {
      "affiliations": [
        "Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Nikhil Tandon"
    },
    {
      "affiliations": [
        "Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia, USA",
        "Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University, Emory University, Atlanta, Georgia, USA",
        "Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA"
      ],
      "name": "Shivani Anil Patel"
    }
  ],
  "title": "Reproductive history, menopause and cardiometabolic health in women: a multicountry analysis",
  "uid": "8567f596-27b1-523a-96d0-1417bd126e74"
}