Does Being a Childfree Impact Women’s Health? Evaluating Cardiovascular Disease Risks Associated With Nulliparity: A Systematic Review and Meta-Analysis

Background and Aims As global trends toward childfree continue to rise, the cardiovascular implications of nulliparity in women remain clinically debated. Although several studies have examined parity-related risks, the relationship between nulliparity and cardiovascular disease remains inadequately synthesized. This study aims to analyze the association of nulliparity with cardiovascular disease risks and to identify the underlying pathophysiological mechanisms. Methods A systematic review and meta-analysis were conducted across Scopus, Elsevier, Cochrane, PubMed, and NHS databases following PICO criteria. Studies assessing parity and cardiovascular outcomes, including major adverse cardiovascular events (MACEs) and metabolic risk factors, were included. The data were synthesized using appropriate statistical analysis software into baseline tables and forest plots (HR/OR) excluding studies with different measurement methods. The final analysis compared cardiovascular disease risks between nulliparous and parous women. Results In eight studies, nulliparous women showed higher risks for CVD (HR: 1.33; 95% CI: 1.12-1.58), CHD (HR: 1.64; 95% CI: 1.14–2.39), Stroke (HR: 1.40; 95% CI: 1.08-1.82), CHD and Stroke (HR: 1.49; 95% CI: 1.08-2.05), HF (HR: 1.46; 95% CI: 1.04-2.05), Hypertension (OR: 1.71; 95% CI: 1.06–2.75), and DM (OR: 1.27; 95% CI: 1.10–1.48). Conversely, five studies indicated that parous groups exhibited lower risks for CVD, CHD, and DM compared to nulliparous women. Conclusion Nulliparity has been associated with cardiovascular risks in women, although outcomes are varied by specific parameters. Further research with rigorous control of confounding variables is required to clarify this relationship.