Pregnancy and risk of cardiovascular disease: is the relationship due to childbearing or childrearing?

Pregnancy has long been considered as a risk factor for cardiovascular disease. However, recent evidence showing similar relationships between the number of children and cardiovascular disease in men suggests that childrearing is more likely than childbearing to affect the risk of cardiovascular disease A major problem in the prevention of cardiovascular disease (CVD) is the difficulty in identifying individuals at high risk at an early enough stage for them to benefit from lifestyle modification or preventive medications. This is especially the case for women, who, on average, develop CVD some 5–10 years later than men. Pregnancy is a factor unique to women and it is now largely recognized that pregnancy complications, such as pre-eclampsia and diabetes are risk factors for the development of CVD or diabetes decades later.1 Furthermore, it has been suggested that the number of pregnancies or live births is associated with the risk of CVD later in life. If causal, more intensive screening of women with multiple pregnancies could therefore support the timely identification of those at the highest risk.